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Views on Early Diagnosis of Alzheimer's Disease Among Dutch Physicians: A Qualitative Interview Study.


ABSTRACT:

Background

Hope for future treatments to prevent or slow down dementia motivates researchers to strive for ever-earlier diagnoses of Alzheimer's disease (AD) based on biomarkers, even before symptoms occur. But is a biomarker-based early diagnosis desirable in clinical practice?

Objective

This study explores the ethical considerations that shape current clinical practice regarding early AD diagnostics and the use of biomarkers.

Methods

In this qualitative study, Dutch physicians were interviewed. Topics included physicians' views concerning early AD diagnosis in persons with no or mild cognitive impairment, physicians' considerations regarding current and expected future practices of early AD diagnosis, the use of biomarkers, and the use of the concepts preclinical and prodromal AD. We analyzed the transcripts using directed content analysis.

Results

15 general practitioners, neurologists, and geriatricians in the Netherlands were interviewed. Most of them interpreted an early AD diagnosis with an early diagnosis of dementia. We identified six clusters of considerations sometimes in favor but most often against pursuing an early AD diagnosis in people with no or mild cognitive impairment that influence physicians' diagnostic decision-making: preferences and characteristics of persons, test characteristics, impact on care, type of setting, disease concepts, and issues on a societal level.

Conclusion

The discussion concerning an early AD diagnosis based on biomarkers which is widely held in the scientific field, has not entered clinical practice structurally. A biomarker-based early diagnosis does not fit within Dutch physicians' views on what good care for people with no, subjective, or mild cognitive impairment should entail.

SUBMITTER: Tromp K 

PROVIDER: S-EPMC7902965 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Views on Early Diagnosis of Alzheimer's Disease Among Dutch Physicians: A Qualitative Interview Study.

Tromp Krista K   Smedinga Marthe M   Richard Edo E   Perry Marieke M   Schermer Maartje H N MHN  

Journal of Alzheimer's disease : JAD 20210101 2


<h4>Background</h4>Hope for future treatments to prevent or slow down dementia motivates researchers to strive for ever-earlier diagnoses of Alzheimer's disease (AD) based on biomarkers, even before symptoms occur. But is a biomarker-based early diagnosis desirable in clinical practice?<h4>Objective</h4>This study explores the ethical considerations that shape current clinical practice regarding early AD diagnostics and the use of biomarkers.<h4>Methods</h4>In this qualitative study, Dutch physi  ...[more]

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