title: Clinical utility and applicability of biomarker-based diagnostic criteria for Alzheimer's disease: a BeDeCo survey.
abstract: We conducted a survey regarding the medical care of patients with dementia in expert settings in Belgium. Open, unrestricted and motivated answers were centralized, blindly interpreted and structured into categories. The report of the results was then submitted to the participants in subsequent plenary meetings and through email. Fourteen experts responded to the questionnaire, confirming that recent propositions to modify Alzheimer's disease (AD) diagnostic criteria and options have stirred up debate among well-informed and dedicated experts in the field. The opinions were not unanimous and illustrate how difficult it is to find a standardized method of diagnosing this disease. The responses to the survey suggest that application of a step-by-step pragmatic method is used in practice. Only when the combination of clinical findings and classical structural neuro-imaging is insufficient for a diagnosis or suggests an atypical presentation, additional biomarkers are considered. Interestingly, few differences, if any, were observed between the use of biomarkers in MCI and in AD. In conclusion, the Belgian experts consulted in this survey were generally in agreement with the new diagnostic criteria for AD, although some concern was expressed about them being too "amyloidocentric". Although the clinical examination, including a full neuropsychological evaluation, is still considered as the basis for diagnosis, most experts also stated that they use biomarkers to help with diagnosis.
authors.affiliation: Department of Neurology, Erasme Hospital, ULB, Route de Lennik, no 808, 1070, Brussels, Belgium. jbier@ulb.ac.be.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bier
authors.affiliation: Expertisecentrum Dementie, Vlaanderen vzw, Antwerp, Belgium.
authors.forename: Jurn
authors.initials: J
authors.lastname: Verschraegen
authors.affiliation: Neurology Department, University Hospitals Leuven, Louvain, Belgium.
authors.forename: Rik
authors.initials: R
authors.lastname: Vandenberghe
authors.affiliation: Centre hospitalier du Bois de l'Abbaye et de Hesbaye, 4100, Seraing, Belgium.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Guillaume
authors.affiliation: Neurology Department, Clinique Saint-Pierre, 1340, Ottignies, Belgium.
authors.forename: Gaëtane
authors.initials: G
authors.lastname: Picard
authors.affiliation: Department of Neurology, Erasme Hospital, ULB, Route de Lennik, no 808, 1070, Brussels, Belgium.
authors.forename: Georges
authors.initials: G
authors.lastname: Otte
authors.affiliation: CHU Dinant Godinne UcL Namur, Service de Neurologie, Université catholique de Louvain, 5530, Yvoir, Belgium.|Institute Of NeuroScience, Université catholique de Louvain, 1348, Louvain-La-Neuve, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Mormont
authors.affiliation: Cognitive and Behavioral Geriatrics, Centre Hospitalier de l'Ardenne, Memory Clinic, Vivalia, Libramont-Chevigny, Belgium.
authors.forename: Christian
authors.initials: C
authors.lastname: Gilles
authors.affiliation: Neurology Department, Brugmann University Hospital, Van Gehuchtenplein 4, 1020, Brussels, Belgium.
authors.forename: Kurt
authors.initials: K
authors.lastname: Segers
authors.affiliation: Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Sieben
authors.affiliation: Department of Neurology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Evert
authors.initials: E
authors.lastname: Thiery
authors.affiliation: Clinique de la Mémoire du GHdC, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Ventura
authors.affiliation: Department of Neurology, Erasme Hospital, ULB, Route de Lennik, no 808, 1070, Brussels, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: De Deyn
authors.affiliation: Neurology Department and Centre for Cognitive Disorders, AZ Sint-Jan Brugge-Oostende, Ostend, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Deryck
authors.affiliation: Department of Neurology, Memory Clinic, UZ Brussel, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Versijpt
authors.affiliation: Centre de la Mémoire, Service de Neurologie, CHU de Liège, et Centre de Recherches du Cyclotron, Université de Liège, Liège, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Salmon
authors.affiliation: Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.|Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Engelborghs
authors.affiliation: Department of Neurology, St Luc Hospital, Institute of Neuroscience, UcL, Brussels, Belgium.
authors.forename: Adrian
authors.initials: A
authors.lastname: Ivanoiu
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000378:metabolism*; D001530:Belgium; D015415:Biomarkers / Q000378:metabolism*; D060825:Cognitive Dysfunction / Q000175:diagnosis; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008511:Medicine / Q000592:standards; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers
keywords: Alzheimer disease; Biomarkers; Diagnosis criteria; Expert opinion; Survey