Translating NIA-AA criteria into usual practice: Report from the ReDeMa Project.
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2024
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Wiley
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Antonio Sánchez-Soblechero; Angel Berbel; Alberto Villarejo; Itziar Palmí-Cortés; Alba Vieira; María José Gil-Moreno; Cristina Fernández; Ãngel Martín-Montes; María Teresa Carreras; Yolanda Fernández; Carolina Puertas; Victor Blanco-Palmero; Sara Llamas; Marta González-Sánchez; Teresa Lapeña; Pilar de Luis; Sagrario Manzano; Javier Olazarán. Translating NIA-AA criteria into usual practice: Report from the ReDeMa Project. Alzheimers Dement (N Y). 10 - 1, pp. 1 - 12. (Estados Unidos de América): Wiley, 2024. ISSN 2352-8737 DOI: 10.1002/trc2.12451
Abstract
Introduction: Biomarker-informed criteria were proposed for the diagnosis of Alzheimer's disease (AD) by the National Institute on Aging and the Alzheimer's Association (NIA-AA) in 2011; however, the adequacy of this criteria has not been sufficiently evaluated.
Methods: ReDeMa (Red de Demencias de Madrid) is a regional cohort of patients attending memory and neurology clinics. Core cerebrospinal fluid biomarkers were obtained, NIA-AA diagnostic criteria were considered, and changes in diagnosis and management were evaluated.
Results: A total of 233 patients were analyzed (mean age 70 years, 50% women, 73% AD). The diagnostic language was modified significantly, with a majority assumption of NIA-AA definitions (69%). Confidence in diagnosis increased from 70% to 92% (p < 0.0005) and management was changed in 71% of patient/caregivers. The influence of neurologist's age or expertise on study results was minimal.
Discussion: The NIA-AA criteria are adequate and utile for usual practice in memory and neurology clinics, improving diagnostic confidence and significantly modifying patient management.
Highlights: Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers increase diagnostic certainty regardless of the neurologist.AD CSF biomarkers lead to changes in disease management .Biomarker-enriched, 2011 NIA-AA diagnostic criteria are adequate for usual practice.