Anja Hviid Simonsen
Danish Dementia Biobank, Denmark
Posters & Accepted Abstracts: Neurochem Neuropharm
This paper presents recommendations, based on the grading of recommendations, assessment, development and evaluation (GRADE) method, for the clinical application of cerebrospinal fluid (CSF) A�²1-42, tau and phosphorylated tau in the diagnostic evaluation of patients with dementia and mild cognitive impairment. The recommendations were developed by a multidisciplinary working group based on available evidence and consensus from focused discussions for identification of AD as the cause of dementia, prediction of rate of decline, cost-effectiveness, interpretation of results, and Patient counseling. The working group found sufficient evidence to support a recommendation to use CSF AD biomarkers as a supplement to clinical evaluation, particularly in uncertain and atypical cases of dementia, in order to identify or exclude AD as the cause of dementia. The working group recommended using CSF AD biomarkers in the diagnostic work-up of MCI patients, following pre-biomarker counseling, as an add-on to clinical evaluation to predict functional decline or conversion to AD dementia, and to guide disease management. Due to insufficient evidence, it was uncertain whether CSF AD biomarkers outperform imaging biomarkers. Furthermore, the working group provided recommendations for interpretation of ambiguous CSF biomarker results and for pre- and post-biomarker counseling.
