Tackling the under-detection and late diagnosis of Alzheimer’s disease

For care planning and support, under-detection and late diagnosis of Alzheimer’s disease (AD) is a great challenge. Models of Patient-Engagement for Alzheimer’s Disease (MOPEAD) is an EU-funded project that aimed at testing different strategies to improve this situation.
The project therefore tested four screening strategies in five countries (Germany, the Netherlands, Slovenia, Spain, and Sweden):
1) a web-approach;
2) Open-House initiative;
3) in primary care; and
4) by diabetes specialists.

Persons-at-risk of AD in all strategies were offered referral to a hospital-based specialist. The primary health-economic outcome was the cost per true-positive case (TP) of AD from the screened population.

Of 2,847 screened persons, 1,121 screened positive (39%), 402 were evaluated at memory clinics (14%), and 236 got an AD diagnosis (8%). The costs associated per TP of those screened was:
€3,115 with the web-approach,
€2,722 with the Open-House,
€1,530 in primary care, and
€1,190 by diabetes specialists.

Sensitivity analyses that more likely reflect the real-world situation confirmed the results. The number-needed-to-screen was 30 with the web-approach, 8 with the Open-House and primary care, and 6 with the diabetes specialists.There were country differences in terms of screening rates, referrals to memory clinics, staff-types involved, and costs per TP.

In primary care and by the diabetes specialist, the costs per TP/screened population were lowest, but the capacity of such settings to identify cases with AD-risk must be discussed. Hence new diagnostic strategies such as web-solutions and Open-House initiatives may be valuable after modifications.

The research leading to these results has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under Grant Agreement No 115985. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations.

Read the full paper here: https://content.iospress.com/articles/journal-of-alzheimers-disease/jad210303

This post is part of our annual campaign entitled “Programme impact analysis – Where we are and where we need to go”. Follow the whole campaign here.