A prospective study investigating the relation between blood‐based biomarkers for Alzheimer’s disease and diagnosis/patient management in primary care: The CANTATE‐PC study
Thomas Claessen, Sinthujah Vigneswaran, Inge M.W. Verberk, Anouk den Braber, Maartje Smit, David Wilson, Melchior C. Nierman, Jurgen A. Kooren, Wiesje M. van der Flier, Argonde C. van Harten, Charlotte E. Teunissen- Psychiatry and Mental health
- Cellular and Molecular Neuroscience
- Geriatrics and Gerontology
- Neurology (clinical)
- Developmental Neuroscience
- Health Policy
- Epidemiology
Abstract
Background
With the advent of disease‐modifying therapies, the need for accurate and cost‐effective diagnosis of Alzheimer’s disease (AD) is high. As the first step in the patient journey, the general practitioner plays an essential role in the diagnostic process. Accurately diagnosing AD in primary care is challenging, because early signs of AD frequently go unrecognized and other forms of dementia may be misdiagnosed as AD. We aim to take a first step towards identifying the utility of a panel of 5 blood‐based biomarkers for AD in primary care, assessing the relation between AD plasma biomarkers, diagnosis and patient management.
Method
Clinical Implementation of Amyloid Neurodegeneration and Tau testing in primary care (CANTATE‐PC) is a prospective study conducted in the Netherlands. CANTATE‐PC aims to enroll 400 participants > 50 years old who present to primary care with cognitive complaints or behavioral changes. Patients with known alcohol or drug abuse are excluded (figure 1). Participants are recruited from 20 primary care practices. At baseline demographic data, medical data and questionnaires regarding global cognitive performance, the nature and severity of cognitive complaints, and iADL are collected from participants (table 1). After enrollment, The general practitioner answers 5 questions about their working diagnosis, patient management and the utility of plasma biomarkers for AD for this individual patient via an online questionnaire, both at baseline and after 6 months. Blood is collected via venipuncture, performed at home or at a local laboratory. Amyloid‐beta42/40 ratio, hyperphosphorylated tau, glial fibrillary acidic protein and neurofilament light are analyzed using Single Molecule Assays (SiMoA, Quanterix Corp.). Primarily, we assess the association between plasma AD biomarkers as predictors and working diagnosis and patient management as outcome measures. Our secondary outcomes are (a) to ascertain if diagnosis and patient management differ between patients with and without plasma evidence of underlying AD (b) to explore associations between plasma biomarkers and the severity of cognitive complaints, global cognitive performance and functioning in iADL and to (c) qualitatively identify scenarios where plasma biomarkers can improve current care.
Result
None
Conclusion
This is the first step towards providing clinical relevance for AD plasma biomarkers in primary care.