Scientific poster - Reducing misdiagnosis of Alzheimer’s disease pathology utilizing CSF and amyloid PET

Poster presented at the AAIC 2022

As we described in the Insight article ‘Improving clinical diagnosis of Alzheimer’s disease’, utilizing cognitive tests alone, like the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), cannot detect the presence of amyloid plaques and tangles in Alzheimer’s disease (AD). While in late stages of AD, clinical diagnosis relying primarily on cognitive testing is correct 70-90% of the time, in mild cognitive impairment (MCI) accuracy is reduced to 50-60%.^1,2 Although autopsy is the gold standard for AD diagnosis, amyloid PET imaging and more recently the Lumipulse G β-Amyloid Ratio (1-42/1-40) in cerebrospinal fluid (CSF) are validated, even CE-IVD marked and FDA-approved, to determine amyloid pathology. With the possible upcoming availability of disease-modifying therapies targeting amyloid in MCI and early AD, and anti-tau drugs in the pipeline, it is necessary to have true measures of AD pathology for a clinical evaluation early in the disease process.

In this poster we examine the performance of cognitive testing alone for identification of amyloid positivity in MCI patients from the ADNI study when compared to amyloid PET and CSF testing. The main conclusion is that CSF measurements or amyloid PET provide greater accuracy in determining amyloid status than cognitive screening tests.

Authors of the poster:
Rianne N. Esquivel^*, Francesca De Simone^*, Natalya Benina^*, Sara Gannon^*, Nathalie Le Bastard^**, Amanda Calabro^*, Douglas M Hawkins^***, Manu Vandijck^**, Jessica Junfola^*, Diana Dickson^*, and Rachel R. Radwan^*.

* Fujirebio Diagnostics Inc, Malvern, PA, USA
** Fujirebio Europe N.V., Ghent, Belgium
*** Douglas Hawkins LLC, Minneapolis, MN, USA

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References

1. Degenhardt E.K. et al. 2016 Psychosomatics 57(2):208-16.

2. Schneider J.A. et al. 2009 Ann Neurol 66(2):200-8.