Benchmarking biomarker-based criteria for Alzheimer's disease: Data from the Swedish Dementia Registry, SveDem

Christoffer Rosén; Bahman Farahmand; Tobias Skillbäck; Katarina Nägga; Niklas Mattsson; Lena Kilander; Dorota Religa; Anders Wimo; Kaj Blennow; Bengt Winblad; Henrik Zetterberg; Maria Eriksdotter

doi:10.1016/j.jalz.2015.04.007

Benchmarking biomarker-based criteria for Alzheimer's disease: Data from the Swedish Dementia Registry, SveDem

Alzheimers Dement. 2015 Dec;11(12):1470-1479. doi: 10.1016/j.jalz.2015.04.007. Epub 2015 Jun 13.

Authors

Affiliations

¹ Clinical Neurochemistry Laboratory, Department of Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden. Electronic address: christoffer.rosen@neuro.gu.se.
² Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden.
³ Clinical Neurochemistry Laboratory, Department of Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
⁴ Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
⁵ Clinical Neurochemistry Laboratory, Department of Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, University of California San Francisco, San Francisco, CA, USA.
⁶ Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden.
⁷ Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden; Center for Alzheimer Research, Division for Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden.
⁸ Center for Alzheimer Research, Division for Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden.
⁹ Clinical Neurochemistry Laboratory, Department of Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.

PMID: 26079415
DOI: 10.1016/j.jalz.2015.04.007

Abstract

Introduction: New research guidelines for the diagnosis of Alzheimer's disease (AD) include biomarker evidence of amyloid-β (Aβ) and tau pathology. The aim of this study was to investigate what proportion of AD patients diagnosed in clinical routine in Sweden that had an AD-indicative cerebrospinal fluid (CSF) biomarker profile.

Methods: By cross-referencing a laboratory database with the Swedish Dementia Registry (SveDem), 2357 patients with data on CSF Aβ and tau biomarkers and a clinical diagnosis of AD with dementia were acquired.

Results: Altogether, 77.2% had pathologic Aβ42 and total tau or phosphorylated tau in CSF. These results were stable across age groups. Female sex and low mini-mental state examination score increased the likelihood of pathologic biomarkers.

Discussion: About a quarter of clinically diagnosed AD patients did not have an AD-indicative CSF biomarker profile. This discrepancy may partly reflect incorrect (false positive) clinical diagnosis or a lack in sensitivity of the biomarker assays.

Keywords: Alzheimer's disease; Biomarkers; Cerebrospinal fluid; Diagnosis; Diagnostic criteria.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alzheimer Disease / cerebrospinal fluid*
Amyloid beta-Peptides / cerebrospinal fluid
Benchmarking / methods*
Biomarkers / cerebrospinal fluid*
Female
Humans
Male
Middle Aged
Peptide Fragments / cerebrospinal fluid
Phosphorylation
Registries
Sex Factors
Sweden
tau Proteins / cerebrospinal fluid

Substances

Amyloid beta-Peptides
Biomarkers
Peptide Fragments
tau Proteins