Ransmayr Gerhard, Eicher Edith, Mraczansky Jürgen, Braoudaki Eirini, Defrancesco Michaela, Struhal Walter, Bancher Christian, Dal-Bianco Peter, Marksteiner Josef, Schmidt Reinhold, Stögmann Elisabeth
Medical Faculty, Johannes-Kepler-University, Linz, Austria.
, Schöpfstr. 6, 6020, Innsbruck, Austria.
Wien Klin Wochenschr. 2025 Sep 5. doi: 10.1007/s00508-025-02608-5.
Disease-modifying therapies with amyloid-antibodies will soon be available for patients with early Alzheimer's disease, which necessitates diagnostic and therapeutic resources in hospital and outpatient settings.
The Austrian Alzheimer Society developed an online questionnaire to survey Austrian hospital-based departments of neurology and psychiatry regarding resources for amyloid-antibody therapies.
Between May and October 2023, 30 out of 41 neurology (73%) and 12 out of 33 psychiatry departments (36%) responded. The number of first examinations per year and center ranges between 0 in centers accepting only secondary referrals and 500, median 100. Of the patients 30% (median; range 0-80%) achieve a mini-mental state examination sum score ≥ 22 constituting an early disease stage. First visits comprise medical history, clinical examination, routine blood sampling and neurocognitive screening in 90-100% of patients, magnetic resonance imaging in 90% (median; range 10-100%), amyloid-PET in 5% (0-70%), cerebrospinal fluid analysis (Aß42, Aß40, tau, phospho-tau) in 25% (0-90%) and Apo‑E testing in 2.5% (0-100%). To assess the amyloid status 18 centers (44%) prefer amyloid-PET to lumbar puncture, 20 (49%) vice versa and 15 centers intend to offer amyloid-antibody therapy. Differences between centers and federal states were observed regarding hospital-based resources for amyloid-antibody therapies. A substantial need exists for early dementia diagnosis, medical, neuropsychological, nursing and administrative resources, adequate space, access to amyloid-PET and MRI. All centers highlighted the need for structured patient pathways and multidisciplinary care networks, including neurologists, psychiatrists, radiologists, neuropsychologists operating in clinical practice, rehabilitation and dementia care settings.
针对早期阿尔茨海默病患者，不久后将有可改变疾病进程的淀粉样蛋白抗体疗法可用，这就需要在医院和门诊环境中配备诊断和治疗资源。
奥地利阿尔茨海默病协会设计了一份在线调查问卷，以调查奥地利各医院的神经内科和精神科关于淀粉样蛋白抗体疗法的资源情况。
在2023年5月至10月期间，41个神经内科科室中有30个（73%）、33个精神科科室中有12个（36%）做出了回应。每年每个中心的首次检查数量在仅接受二次转诊的中心为0例至500例之间，中位数为100例。30%（中位数；范围0 - 80%）的患者在简易精神状态检查表上的总分≥22分，处于疾病早期阶段。90 - 100%的患者首次就诊包括病史采集、临床检查、常规血液采样和神经认知筛查，90%（中位数；范围10 - 100%）的患者进行磁共振成像检查，5%（0 - 70%）的患者进行淀粉样蛋白PET检查，25%（0 - 90%）的患者进行脑脊液分析（Aβ42、Aβ40、tau、磷酸化tau蛋白），2.5%（0 - 100%）的患者进行载脂蛋白E检测。为评估淀粉样蛋白状态，18个中心（44%）更倾向于使用淀粉样蛋白PET而非腰椎穿刺，20个中心（49%）则相反，15个中心打算提供淀粉样蛋白抗体疗法。在淀粉样蛋白抗体疗法的医院资源方面，各中心和联邦州之间存在差异。对于早期痴呆症诊断、医疗、神经心理学、护理和行政资源、充足的空间、淀粉样蛋白PET和MRI检查的获取，存在大量需求。所有中心都强调需要有结构化的患者就医流程和多学科护理网络，包括在临床实践、康复和痴呆症护理环境中工作的神经科医生、精神科医生、放射科医生、神经心理学家。
