A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting

Ingrid S van Maurik; Hana M Broulikova; Arenda Mank; Els D Bakker; Arno de Wilde; Femke H Bouwman; Andrew W Stephens; Bart N M van Berckel; Philip Scheltens; Wiesje M van der Flier

doi:10.1002/alz.12846

A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting

Ingrid S van Maurik, Hana M Broulikova, Arenda Mank, Els D Bakker, Arno de Wilde, Femke H Bouwman, Andrew W Stephens, Bart N M van Berckel, Philip Scheltens, Wiesje M van der Flier

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

INTRODUCTION: We aim to study the effect of a more precise diagnosis, by means of amyloid positron emission tomography (PET), on institutionalization, mortality, and health-care costs.

METHODS: Between October 27, 2014 and December 31, 2016, we offered amyloid PET to all patients as part of their diagnostic work-up. Patients who accepted to undergo amyloid PET (n = 449) were propensity score matched with patients without amyloid PET (n = 571, i.e., no PET). Matched groups (both n = 444) were compared on rate of institutionalization, mortality, and health-care costs in the years after diagnosis.

RESULTS: Amyloid PET patients had a lower risk of institutionalization (10% [n = 45] vs. 21% [n = 92]; hazard ratio [HR] = 0.48 [0.33-0.70]) and mortality rate (11% [n = 49] vs. 18% [n = 81]; HR = 0.51 [0.36-0.73]) and lower health-care costs in the years after diagnosis compared to matched no-PET patients (β = -4573.49 [-6524.76 to -2523.74], P-value < 0.001).

DISCUSSION: A more precise diagnosis in tertiary memory clinic patients positively influenced the endpoints of institutionalization, death, and health-care costs.

Original language	English
Pages (from-to)	2006-2013
Number of pages	8
Journal	Alzheimer's & dementia : the journal of the Alzheimer's Association
Volume	19
Issue number	5
Early online date	23 Nov 2022
DOIs	https://doi.org/10.1002/alz.12846
Publication status	Published - May 2023

Bibliographical note

Funding

Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. WMvdF holds the Pasman chair. This project was conducted in the context of the collaboration project ABIDE‐clinical utility, which is funded by the PPP Allowance made available by health‐Holland, Top Sector Life Sciences & Health, to stimulate public–private partnerships and co‐funded by Life Molecular Imaging GmbH (grant no.: LSHM18075). Andrew Stephens is full‐time employee of Life‐MI. He had no involvement in study design, data collection, data analysis or data interpretation, but he was involved in revising the manuscript and approved the manuscript for submission.WMvdF and ISvM are recipients of the the EU Joint Programme Neurodegenerative Disease Research project ADDITION (ZonMW, grant no. 733051083). WMvdF is recipient of ABOARD, which is a public–private partnership receiving funding from ZonMW (#73305095007), Alzheimer Nederland and Health∼Holland, Topsector Life Sciences & Health (PPP‐allowance; #LSHM20106). More than 30 partners contribute to ABOARD. ABOARD also receives financial support from Gieskes‐Strijbisfonds and Edwin Bouw Fonds. H. Broulikova, A. Mank, E.D. Bakker, and F.H. Bouwman report no financial disclosures or conflicts of interest. Ingrid S. van Maurik received a consultancy fee (paid to the university) from Roche. A. de Wilde is employee of Life Sciences Partners (EQT Life Sciences) Amsterdam. Andrew Stephens is a full‐time employee of Life Molecular Imaging GmbH. Van Berckel has received research support from EU‐FP7, CTMM, ZonMw, NWO, and Alzheimer Nederland. B. vB has performed contract research for Rodin, IONIS, AVID, Eli Lilly, UCB, DIAN‐TUI, and Janssen. B. vB was a speaker at a symposium organized by Springer Healthcare. B. vB has a consultancy agreement with IXICO for the reading of PET scans. B. vB is a trainer for GE. B. vB only receives financial compensation from Amsterdam UMC. Philip Scheltens has received consultancy fees (paid to the university) from AC Immune, Alzheon, Brainstorm Cell, ImmunoBrain Checkpoint, Novartis, and Novo Nordisk. Within his university affiliation he is PI of studies with AC Immune, FUJI‐film/Toyama, IONIS, UCB, and Vivoryon. He is also an employee of Life Sciences Partners (EQT Life Sciences) Amsterdam. Research programs of Wiesje van der Flier have been funded by ZonMW, NWO, EU‐FP7, EU‐JPND, Alzheimer Nederland, Hersenstichting CardioVascular Onderzoek Nederland, Health∼Holland, Topsector Life Sciences & Health, stichting Dioraphte, Gieskes‐Strijbis fonds, stichting Equilibrio, Edwin Bouw fonds, Pasman stichting, stichting Alzheimer & Neuropsychiatrie Foundation, Philips, Biogen MA Inc., Novartis‐NL, Life‐MI, AVID, Roche BV, Fujifilm, and Combinostics. W.F. holds the Pasman chair. W.F. is recipient of ABOARD, which is a public–private partnership receiving funding from ZonMW (#73305095007) and Health∼Holland, Topsector Life Sciences & Health (PPP‐allowance; #LSHM20106). W.F. has performed contract research for Biogen MA Inc., and Boehringer Ingelheim. W.F. has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., Danone, Eisai, WebMD Neurology (Medscape), and Springer Healthcare. W.F. is a consultant to Oxford Health Policy Forum CIC, Roche, and Biogen MA Inc. W.F. participated in advisory boards of Biogen MA Inc. and Roche. All funding is paid to her institution. W.F. was an associate editor of in 2020/2021. W.F. is associate editor at . Author disclosures are available in the supporting information. Alzheimer, Research & Therapy Brain Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. WMvdF holds the Pasman chair. This project was conducted in the context of the collaboration project ABIDE-clinical utility, which is funded by the PPP Allowance made available by health-Holland, Top Sector Life Sciences & Health, to stimulate public–private partnerships and co-funded by Life Molecular Imaging GmbH (grant no.: LSHM18075). Andrew Stephens is full-time employee of Life-MI. He had no involvement in study design, data collection, data analysis or data interpretation, but he was involved in revising the manuscript and approved the manuscript for submission.WMvdF and ISvM are recipients of the the EU Joint Programme Neurodegenerative Disease Research project ADDITION (ZonMW, grant no. 733051083). WMvdF is recipient of ABOARD, which is a public–private partnership receiving funding from ZonMW (#73305095007), Alzheimer Nederland and Health∼Holland, Topsector Life Sciences & Health (PPP-allowance; #LSHM20106). More than 30 partners contribute to ABOARD. ABOARD also receives financial support from Gieskes-Strijbisfonds and Edwin Bouw Fonds.

Funders	Funder number
Alzheimer & Neuropsychiatrie Foundation
Alzheimer Nederland and Health∼Holland
Biogen MA Inc.
EU‐JPND
Gieskes-Strijbisfonds and Edwin Bouw Fonds
Gieskes‐Strijbisfonds and Edwin Bouw Fonds
Life Molecular Imaging GmbH	LSHM18075
Topsector Life Sciences & Health
Philips
Roche	73305095007, 20106
EU Joint Programme – Neurodegenerative Disease Research
Health~Holland
ZonMw	733051083
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	EU‐FP7

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van Maurik, I. S., Broulikova, H. M., Mank, A., Bakker, E. D., de Wilde, A., Bouwman, F. H., Stephens, A. W., van Berckel, B. N. M., Scheltens, P., & van der Flier, W. M. (2023). A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting. Alzheimer's & dementia : the journal of the Alzheimer's Association, 19(5), 2006-2013. https://doi.org/10.1002/alz.12846

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title = "A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting",

abstract = "INTRODUCTION: We aim to study the effect of a more precise diagnosis, by means of amyloid positron emission tomography (PET), on institutionalization, mortality, and health-care costs.METHODS: Between October 27, 2014 and December 31, 2016, we offered amyloid PET to all patients as part of their diagnostic work-up. Patients who accepted to undergo amyloid PET (n = 449) were propensity score matched with patients without amyloid PET (n = 571, i.e., no PET). Matched groups (both n = 444) were compared on rate of institutionalization, mortality, and health-care costs in the years after diagnosis.RESULTS: Amyloid PET patients had a lower risk of institutionalization (10\% [n = 45] vs. 21\% [n = 92]; hazard ratio [HR] = 0.48 [0.33-0.70]) and mortality rate (11\% [n = 49] vs. 18\% [n = 81]; HR = 0.51 [0.36-0.73]) and lower health-care costs in the years after diagnosis compared to matched no-PET patients (β = -4573.49 [-6524.76 to -2523.74], P-value < 0.001).DISCUSSION: A more precise diagnosis in tertiary memory clinic patients positively influenced the endpoints of institutionalization, death, and health-care costs.",

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van Maurik, IS, Broulikova, HM, Mank, A, Bakker, ED, de Wilde, A, Bouwman, FH, Stephens, AW, van Berckel, BNM, Scheltens, P & van der Flier, WM 2023, 'A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting', Alzheimer's & dementia : the journal of the Alzheimer's Association, vol. 19, no. 5, pp. 2006-2013. https://doi.org/10.1002/alz.12846

A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting. / van Maurik, Ingrid S; Broulikova, Hana M; Mank, Arenda et al.
In: Alzheimer's & dementia : the journal of the Alzheimer's Association, Vol. 19, No. 5, 05.2023, p. 2006-2013.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting

AU - van Maurik, Ingrid S

AU - Broulikova, Hana M

AU - Mank, Arenda

AU - Bakker, Els D

AU - de Wilde, Arno

AU - Bouwman, Femke H

AU - Stephens, Andrew W

AU - van Berckel, Bart N M

AU - Scheltens, Philip

AU - van der Flier, Wiesje M

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N2 - INTRODUCTION: We aim to study the effect of a more precise diagnosis, by means of amyloid positron emission tomography (PET), on institutionalization, mortality, and health-care costs.METHODS: Between October 27, 2014 and December 31, 2016, we offered amyloid PET to all patients as part of their diagnostic work-up. Patients who accepted to undergo amyloid PET (n = 449) were propensity score matched with patients without amyloid PET (n = 571, i.e., no PET). Matched groups (both n = 444) were compared on rate of institutionalization, mortality, and health-care costs in the years after diagnosis.RESULTS: Amyloid PET patients had a lower risk of institutionalization (10% [n = 45] vs. 21% [n = 92]; hazard ratio [HR] = 0.48 [0.33-0.70]) and mortality rate (11% [n = 49] vs. 18% [n = 81]; HR = 0.51 [0.36-0.73]) and lower health-care costs in the years after diagnosis compared to matched no-PET patients (β = -4573.49 [-6524.76 to -2523.74], P-value < 0.001).DISCUSSION: A more precise diagnosis in tertiary memory clinic patients positively influenced the endpoints of institutionalization, death, and health-care costs.

AB - INTRODUCTION: We aim to study the effect of a more precise diagnosis, by means of amyloid positron emission tomography (PET), on institutionalization, mortality, and health-care costs.METHODS: Between October 27, 2014 and December 31, 2016, we offered amyloid PET to all patients as part of their diagnostic work-up. Patients who accepted to undergo amyloid PET (n = 449) were propensity score matched with patients without amyloid PET (n = 571, i.e., no PET). Matched groups (both n = 444) were compared on rate of institutionalization, mortality, and health-care costs in the years after diagnosis.RESULTS: Amyloid PET patients had a lower risk of institutionalization (10% [n = 45] vs. 21% [n = 92]; hazard ratio [HR] = 0.48 [0.33-0.70]) and mortality rate (11% [n = 49] vs. 18% [n = 81]; HR = 0.51 [0.36-0.73]) and lower health-care costs in the years after diagnosis compared to matched no-PET patients (β = -4573.49 [-6524.76 to -2523.74], P-value < 0.001).DISCUSSION: A more precise diagnosis in tertiary memory clinic patients positively influenced the endpoints of institutionalization, death, and health-care costs.

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van Maurik IS, Broulikova HM, Mank A, Bakker ED, de Wilde A, Bouwman FH et al. A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2023 May;19(5):2006-2013. Epub 2022 Nov 23. doi: 10.1002/alz.12846

A more precise diagnosis by means of amyloid PET contributes to delayed institutionalization, lower mortality, and reduced care costs in a tertiary memory clinic setting

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