Current approaches and clinician attitudes to the use of cerebrospinal fluid biomarkers in diagnostic evaluation of dementia in Europe

Anne Marie Miller, Mircea Balasa, Kaj Blennow, Mary Gardiner, Aleksandra Rutkowska, Philip Scheltens, Charlotte E. Teunissen, Pieter Jelle Visser, Bengt Winblad, Gunhild Waldemar, Brian Lawlor

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Background: BIOMARKAPD seeks to diminish the barriers associated with the clinical use of cerebrospinal fluid (CSF) biomarker analysis by reducing variation in CSF laboratory methodologies and generating consensus recommendations on their clinical interpretation and application for dementia diagnosis. Objective: To examine the disparity in practitioner attitudes and clinical practice relating to the use of CSF biomarkers for dementia diagnosis across Europe. Methods: Clinical dementia experts were surveyed on the prevalence of national consensus guidelines and analytical reimbursement across Europe, their biomarker platform preferences, lumbar puncture methodologies and application of reference values and cut-offs for CSF analysis. Results: 74% of respondents (total n = 51) use CSF biomarkers in clinical practice and 69% perform lumbar punctures on an outpatient basis. Most use CSF biomarkers to diagnose atypical (84%) and early-onset cases of cognitive impairment (71%) and for the differential diagnosis of other dementias (69%). 82% state they are sufficiently informed about CSF biomarkersyet 61% report a lack of national consensus guidelines on their use for dementia diagnosis. 48% of countries represented do not reimburse clinical CSF analysis costs. 43% report using normal reference ranges derived from publications. Conclusion: Variations in attitude and practice relating to CSF biomarkers, widely recognised as barriers to their clinical acceptance, remain evident within and between countries across Europe, even in expert centres. These shortcomings must be addressed by developing consensus guidelines on CSF-related methodologies and their clinical application, to further their use for the diagnostic evaluation of dementia.

Original languageEnglish
Pages (from-to)201-210
Number of pages10
JournalJournal of Alzheimer's Disease
Volume60
Issue number1
DOIs
Publication statusPublished - 2017

Keywords

  • Alzheimer's disease
  • attitudes
  • biomarkers
  • cerebrospinal fluid
  • dementia

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