Skip to main content

Advertisement

SpringerLink
Log in

Clinical utility and applicability of biomarker-based diagnostic criteria for Alzheimer’s disease: a BeDeCo survey

  • Original Article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

We conducted a survey regarding the medical care of patients with dementia in expert settings in Belgium. Open, unrestricted and motivated answers were centralized, blindly interpreted and structured into categories. The report of the results was then submitted to the participants in subsequent plenary meetings and through email. Fourteen experts responded to the questionnaire, confirming that recent propositions to modify Alzheimer’s disease (AD) diagnostic criteria and options have stirred up debate among well-informed and dedicated experts in the field. The opinions were not unanimous and illustrate how difficult it is to find a standardized method of diagnosing this disease. The responses to the survey suggest that application of a step-by-step pragmatic method is used in practice. Only when the combination of clinical findings and classical structural neuro-imaging is insufficient for a diagnosis or suggests an atypical presentation, additional biomarkers are considered. Interestingly, few differences, if any, were observed between the use of biomarkers in MCI and in AD. In conclusion, the Belgian experts consulted in this survey were generally in agreement with the new diagnostic criteria for AD, although some concern was expressed about them being too “amyloidocentric”. Although the clinical examination, including a full neuropsychological evaluation, is still considered as the basis for diagnosis, most experts also stated that they use biomarkers to help with diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Boller F, Forbes MM (1998) History of dementia and dementia in history: an overview. J Neurol Sci 158(2):125–133

    Article  CAS  PubMed  Google Scholar 

  2. Jack CR Jr, Albert MS, Knopman DS et al (2011) Introduction to the recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:257–262

    Article  PubMed Central  PubMed  Google Scholar 

  3. Petersen RC, Smith GE, Waring SC et al (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56:03–08

    Article  Google Scholar 

  4. Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256:183–194

    Article  CAS  PubMed  Google Scholar 

  5. Dubois B, Feldman HH, Jacova C et al (2010) Revising the definition of Alzheimer’s disease: a new lexicon. Lancet Neurol 9:1118–1127

    Article  PubMed  Google Scholar 

  6. Dubois B, Feldman HH, Jacova C et al (2014) Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 13:614–629

    Article  PubMed  Google Scholar 

  7. Sperling RA, Aisen PS, Beckett LA et al (2011) Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7(3):280–292

    Article  PubMed Central  PubMed  Google Scholar 

  8. Albert MS, DeKosky ST, Dickson D et al (2011) The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:270–279

    Article  PubMed Central  PubMed  Google Scholar 

  9. McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269

    Article  PubMed Central  PubMed  Google Scholar 

  10. Jiha GA, Rentz DM (2013) Cognitive and brain reserve and the diagnosis and treatment of preclinical Alzheimer disease. Neurology 80:1–2

    Article  Google Scholar 

  11. Jack CR, Wiste HJ, Lesnick TG et al (2013) Brain β-amyloid load approaches a plateau. Neurology 80:890–897

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Vuoksimaa E, Panizzon MS, Chen CH et al (2013) Cognitive reserve moderates the association between hippocampal volume and episodic memory in middle age. Neuropsychologia 51(6):1124–1131

    Article  PubMed Central  PubMed  Google Scholar 

  13. Montine TJ, Phelps CH et al (2012) National Institute on Aging-Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approach. Acta Neuropathol 123:1–11

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Jack CR Jr, Holtzman DM (2013) Biomarker modeling of Alzheimer’s disease. Neuron 80(6):1347–1358

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Bennett DA, Schneider JA, Arvanitakis Z et al (2006) Neuropathology of older persons without cognitive impairment from two community-based studies. Neurology 66(12):1837–1844

    Article  CAS  PubMed  Google Scholar 

  16. Vandenberghe R, Adamczuk K, Dupont P et al (2013) Amyloid PET in clinical practice: its place in the multidimensional space of Alzheimer’s disease. Neuroimage Clin 2:497–511

    Article  PubMed Central  PubMed  Google Scholar 

  17. Biomarkers definitions working group (2001) Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther 69(3):89–95

    Article  Google Scholar 

  18. Scheltens P, van der Pol L (2012) Impact commentaries. Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry 83(11):1038–1040

    Article  PubMed  Google Scholar 

  19. Frisoni GB, Fox NC, Jack CR Jr et al (2010) The clinical use of structural MRI in Alzheimer disease. Nat Rev Neurol 6(2):67–77

    Article  PubMed Central  PubMed  Google Scholar 

  20. Klunk WE, Engler H, Nordberg A et al (2004) Imaging brain amyloid in Alzheimer’s disease with Pittsburgh Compound-B. Ann Neurol 55(3):306–319

    Article  CAS  PubMed  Google Scholar 

  21. Vandenberghe R, Van Laere K, Ivanoiu A et al (2010) 18F-flutemetamol amyloid imaging in Alzheimer disease and mild cognitive impairment: a phase 2 trial. Ann Neurol 68:319–329

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the University of Antwerp Research Fund and the Alzheimer Research Foundation (SAO-FRA).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurology, Erasme Hospital, ULB, Route de Lennik, no 808, 1070, Brussels, Belgium

    Jean-Christophe Bier, Georges Otte & Peter De Deyn

  2. Expertisecentrum Dementie, Vlaanderen vzw, Antwerp, Belgium

    Jurn Verschraegen

  3. Neurology Department, University Hospitals Leuven, Louvain, Belgium

    Rik Vandenberghe

  4. Centre hospitalier du Bois de l’Abbaye et de Hesbaye, 4100, Seraing, Belgium

    Bénédicte Guillaume

  5. Neurology Department, Clinique Saint-Pierre, 1340, Ottignies, Belgium

    Gaëtane Picard

  6. CHU Dinant Godinne UcL Namur, Service de Neurologie, Université catholique de Louvain, 5530, Yvoir, Belgium

    Eric Mormont

  7. Institute Of NeuroScience, Université catholique de Louvain, 1348, Louvain-La-Neuve, Belgium

    Eric Mormont

  8. Cognitive and Behavioral Geriatrics, Centre Hospitalier de l’Ardenne, Memory Clinic, Vivalia, Libramont-Chevigny, Belgium

    Christian Gilles

  9. Neurology Department, Brugmann University Hospital, Van Gehuchtenplein 4, 1020, Brussels, Belgium

    Kurt Segers

  10. Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium

    Anne Sieben & Evert Thiery

  11. Clinique de la Mémoire du GHdC, Grand Hôpital de Charleroi, Charleroi, Belgium

    Manfredi Ventura

  12. Neurology Department and Centre for Cognitive Disorders, AZ Sint-Jan Brugge-Oostende, Ostend, Belgium

    Olivier Deryck

  13. Department of Neurology, Memory Clinic, UZ Brussel, Brussels, Belgium

    Jan Versijpt

  14. Centre de la Mémoire, Service de Neurologie, CHU de Liège, et Centre de Recherches du Cyclotron, Université de Liège, Liège, Belgium

    Eric Salmon

  15. Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium

    Sebastiaan Engelborghs

  16. Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium

    Sebastiaan Engelborghs

  17. Department of Neurology, St Luc Hospital, Institute of Neuroscience, UcL, Brussels, Belgium

    Adrian Ivanoiu

Authors
  1. Jean-Christophe Bier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jurn Verschraegen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rik Vandenberghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bénédicte Guillaume
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gaëtane Picard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Georges Otte
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eric Mormont
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Christian Gilles
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kurt Segers
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Anne Sieben
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Evert Thiery
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Manfredi Ventura
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Peter De Deyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Olivier Deryck
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Jan Versijpt
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Eric Salmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Sebastiaan Engelborghs
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Adrian Ivanoiu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Christophe Bier.

Appendix

Appendix

Category definition:

  • Agrees (A): The expert agrees fully and without reserve with the assertion and he/she applies/advises it.

  • Rather agrees (RA): The expert agrees partially and with some reserve with the assertion and he/she applies/or advises it in a majority of cases in his/her practice.

  • Rather disagrees (RD): The expert agrees only with some aspects of the assertion and he/she only applies/or advises it in a minority of cases in his/her practice.

  • Disagrees (D): The expert disagrees totally with the assertion and he/she does not apply/or advice it in practice.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bier, JC., Verschraegen, J., Vandenberghe, R. et al. Clinical utility and applicability of biomarker-based diagnostic criteria for Alzheimer’s disease: a BeDeCo survey. Acta Neurol Belg 115, 547–555 (2015). https://doi.org/10.1007/s13760-014-0423-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-014-0423-7

Keywords

Search

Navigation