L'application en clinique des critères diagnostiques IWG pour la maladie d'Alzheimer: Étude rétrospective dans une clinique de la mémoire

Introduction: In recent years knowledge about Alzheimer's disease (AD) presented a major change since the availability of new diagnostic criteria incorporating biomarkers within the known cl inical criteria. Such criteria were elaborated by NIA-AA (National Institute on Aging - Alzheimer's Association) for clinical use and IWG (International Working Group) for research purpose. The aim of this study is to investigate the use of complementary examinations included in the NIA-AA and IWG criteria in a memory clinic characterized by a heterogenous population of patients. Methods: We retrospectively reviewed patient's characteristics of cases consulting between 01/01/2010 and 31/12/2013 based on the implementation of three additional tests: neuropsychological testing, measurement of cerebrospinal fluid (CSF) biomarkers and brain MRI. Patients were compared according to their origins. Results: 919 patients' medical records were included in the study, 20 % of which were from immigrant background. Non-European Union migrants underwent less neuropsychological testing and more lumbar punctures in comparison with the local population. Conclusion: CSF biomarkers allow defining an objective diagnostic component of AD by suppressing the variability due to language, culture, education and the clinical presentation of the disease. Despite the known use in the research domain but not yet validated for clinical use, the IWG criteria are applied in heterogeneous populations with a high percentage of migrants, especially when the results of the neuropsychological testing are poorly contributive. We expect recommendations for clinical use of the CSF biomarkers or better cognitive assessment methods for these populations in the future.SCOPUS: ar.j