Experience in a primary care inpatient hospital (Comárcal) with the use of CSF results for the diferential diagnosis of Alzheimer’s disease

Abstract

AbstractBackgroundTo analyze the usefulness of the use of Alzheimer’s disease (AD) biomarkers in cerebrospinal fluid (CSF) since its incorporation into clinical practice, in a first‐line care hospital setting.MethodWe review clinical history, neuroimaging and neuropsychology, and results of B‐amyloid 42, B‐amyloid 42/40 ratio, total tau and p‐tau in CSF in patients who consulted for cognitive impairment. Prior to biomarker determination, they were assigned a degree of suspicion based on history, neuroimaging and neuropsychology. Afterwards, they were reclassified into probable AD/ dementia not AD/no evidence of AD or neurodegeneration according to the ATN system. Finally, the usefulness was assessed according to whether a high degree of diagnostic certainty was achieved in each case.Result39 patients gave ICF and were analyzed; mean age 69.5 years; cases with typical and atypical clinical course. After determination of biomarkers, they were classified according to whether they presented A+/A‐, T+/T‐ and N+/N‐; findings were correlated with previous clinical and paraclinical data and compared with them, and stratified according to the degree of diagnostic certainty provided. A high degree of diagnostic certainty was achieved in 34/39 patients.Conclusiondetermination of CSF biomarkers is a useful, affordable and decisive tool in the differential diagnosis of patients with Alzheimer’s disease, which makes it a diagnostic resource to be used preferably even in primary health care hospitals.