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Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Alzheimer's Disease | Research article

The MemClin project: a prospective multi memory clinics study targeting early stages of cognitive impairment

Authors: Urban Ekman, Daniel Ferreira, J-Sebastian Muehlboeck, John Wallert, Anna Rennie, Maria Eriksdotter, Lars-Olof Wahlund, Eric Westman

Published in: BMC Geriatrics | Issue 1/2020

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Abstract

Background

There remains a lack of large-scale clinical studies of cognitive impairment that aim to increase diagnostic and prognostic accuracy as well as validate previous research findings. The MemClin project will amass large quantities of cross-disciplinary data allowing for the construction of robust models to improve diagnostic accuracy, expand our knowledge on differential diagnostics, strengthen longitudinal prognosis, and harmonise examination protocols across centres. The current article describes the Memory Clinic (MemClin) project’s study-design, materials and methods, and patient characteristics. In addition, we present preliminary descriptive data from the ongoing data collection.

Methods

Nine out of ten memory clinics in the greater Stockholm area, which largely use the same examination methods, are included. The data collection of patients with different stages of cognitive impairment and dementia is coordinated centrally allowing for efficient and secure large-scale database construction. The MemClin project rest directly on the memory clinics examinations with cognitive measures, health parameters, and biomarkers.

Results

Currently, the MemClin project has informed consent from 1543 patients. Herein, we present preliminary data from 835 patients with confirmed cognitive diagnosis and neuropsychological test data available. Of those, 239 had dementia, 487 mild cognitive impairment (MCI), and 104 subjective cognitive impairment (SCI). In addition, we present descriptive data on visual ratings of brain atrophy and cerebrospinal fluid markers.

Conclusions

Based on our current progress and preliminary data, the MemClin project has a high potential to provide a large-scale database of 1200–1500 new patients annually. This coordinated data collection will allow for the construction of improved diagnostic and prognostic models for neurodegenerative disorders and other cognitive conditions in their naturalistic setting.
Literature
1.
go back to reference Global action plan on the public health response to dementia 2017–2025. Geneva: World Health Organization; 2017. ISBN 78-92-4-151348-7; Licence: CC BY-NC-SA 3.0 IGO. Global action plan on the public health response to dementia 2017–2025. Geneva: World Health Organization; 2017. ISBN 78-92-4-151348-7; Licence: CC BY-NC-SA 3.0 IGO.
2.
go back to reference Prina AM, Mayston R, Tzu Y, Martin W. A review of the 10/66 dementia research group. Soc Psychiatry Psychiatr Epidemiol. 2019;54:1–10.CrossRef Prina AM, Mayston R, Tzu Y, Martin W. A review of the 10/66 dementia research group. Soc Psychiatry Psychiatr Epidemiol. 2019;54:1–10.CrossRef
3.
go back to reference Alzheimer’s disease facts and figures. Alzheimer’s Dement, vol. 15; 2019. p. 321–87. Alzheimer’s disease facts and figures. Alzheimer’s Dement, vol. 15; 2019. p. 321–87.
4.
go back to reference Nilsson L-G, Bäckman L, Erngrund K, Nyberg L, Adolfsson R, Bucht G, et al. The betula prospective cohort study: memory, health, and aging. Aging Neuropsychol Cogn. 1997;4:1–32.CrossRef Nilsson L-G, Bäckman L, Erngrund K, Nyberg L, Adolfsson R, Bucht G, et al. The betula prospective cohort study: memory, health, and aging. Aging Neuropsychol Cogn. 1997;4:1–32.CrossRef
5.
go back to reference Park DC, Smith AD, Lautenschlager G, Earles JL, Frieske D, Zwahr M, et al. Mediators of Long-Term Memory Performance Across the Life Span. Psychol Aging. 1996;II:621–37.CrossRef Park DC, Smith AD, Lautenschlager G, Earles JL, Frieske D, Zwahr M, et al. Mediators of Long-Term Memory Performance Across the Life Span. Psychol Aging. 1996;II:621–37.CrossRef
6.
go back to reference Machado A, Barosso J, Molina T, Nieto A, Diaz-Flores L, Westman E, et al. Proposal for a hierarchical, multidimensional, and multivariate approach to investigate cognitive aging. Neurobiol Aging. 2018;71:179–88.CrossRef Machado A, Barosso J, Molina T, Nieto A, Diaz-Flores L, Westman E, et al. Proposal for a hierarchical, multidimensional, and multivariate approach to investigate cognitive aging. Neurobiol Aging. 2018;71:179–88.CrossRef
7.
go back to reference Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr. 1997;9:65–9.CrossRef Petersen RC, Smith GE, Waring SC, Ivnik RJ, Kokmen E, Tangelos EG. Aging, memory, and mild cognitive impairment. Int Psychogeriatr. 1997;9:65–9.CrossRef
8.
go back to reference Aerts L, Heffernan M, Kochan NA, Crawford JD, Draper B, Trollor JN. Effects of MCI subtype and reversion on progression to dementia in a community sample. Neurology. 2017;88:2225–32.CrossRef Aerts L, Heffernan M, Kochan NA, Crawford JD, Draper B, Trollor JN. Effects of MCI subtype and reversion on progression to dementia in a community sample. Neurology. 2017;88:2225–32.CrossRef
9.
go back to reference Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256:183–94.CrossRef Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256:183–94.CrossRef
10.
go back to reference Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund L-O, et al. Mild cognitive impairment--beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. J Intern Med. 2004;256:240–6.CrossRef Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund L-O, et al. Mild cognitive impairment--beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. J Intern Med. 2004;256:240–6.CrossRef
11.
go back to reference Jessen F, Amariglio RE, Van Boxtel M, Breteler M, Ceccaldi M, Chételat G, et al. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimers Dement. 2014;10:844–52.CrossRef Jessen F, Amariglio RE, Van Boxtel M, Breteler M, Ceccaldi M, Chételat G, et al. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer’s disease. Alzheimers Dement. 2014;10:844–52.CrossRef
12.
go back to reference Molinuevo JL, Rabin LA, Amariglio R, Buckley R, Dubois B, Ellis KA, et al. Implementation of subjective cognitive decline criteria in research studies. Alzheimers Dement. 2017;13:296–311.CrossRef Molinuevo JL, Rabin LA, Amariglio R, Buckley R, Dubois B, Ellis KA, et al. Implementation of subjective cognitive decline criteria in research studies. Alzheimers Dement. 2017;13:296–311.CrossRef
13.
go back to reference Johansson L, Kern S, Sigstr R, Guo X, Ostling S. Increased risk of dementia in subjective cognitive decline if CT brain changes are present. J Alzheimers Dis. 2018;66:483–95.CrossRef Johansson L, Kern S, Sigstr R, Guo X, Ostling S. Increased risk of dementia in subjective cognitive decline if CT brain changes are present. J Alzheimers Dis. 2018;66:483–95.CrossRef
14.
go back to reference Slot RER, Sikkes SAM, Berkhof J, Brodaty H, Buckley R, Cavedo E, et al. Subjective cognitive decline and rates of incident Alzheimer’s disease and non–Alzheimer’s disease dementia. Alzheimers Dement. 2019;15:465–76.CrossRef Slot RER, Sikkes SAM, Berkhof J, Brodaty H, Buckley R, Cavedo E, et al. Subjective cognitive decline and rates of incident Alzheimer’s disease and non–Alzheimer’s disease dementia. Alzheimers Dement. 2019;15:465–76.CrossRef
15.
go back to reference Bibl M, Esselmann H, Wiltfang J. Neurochemical biomarkers in Alzheimer’s disease and related disorders. Ther Adv Neurol Disord. 2012;5:335–48.CrossRef Bibl M, Esselmann H, Wiltfang J. Neurochemical biomarkers in Alzheimer’s disease and related disorders. Ther Adv Neurol Disord. 2012;5:335–48.CrossRef
16.
go back to reference Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA research framework: toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018;14:535–62.CrossRef Jack CR, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA research framework: toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018;14:535–62.CrossRef
17.
go back to reference Kuller LH. A new era for dementia epidemiology: Alzheimer’s disease, hardening of arteries, or just old age? Eur J Epidemiol. 2018;33:613–6.CrossRef Kuller LH. A new era for dementia epidemiology: Alzheimer’s disease, hardening of arteries, or just old age? Eur J Epidemiol. 2018;33:613–6.CrossRef
18.
go back to reference Jack C, Bennett D, Blennow K, Carrillo M, Feldman H, Frisoni G, et al. A/T/N: an unbiased descriptive classification scheme for Alzheimer disease biomarkers. Neurology. 2016;87:539–47.CrossRef Jack C, Bennett D, Blennow K, Carrillo M, Feldman H, Frisoni G, et al. A/T/N: an unbiased descriptive classification scheme for Alzheimer disease biomarkers. Neurology. 2016;87:539–47.CrossRef
19.
go back to reference Ekman U, Ferreira D, Westman E. The a/T/N biomarker scheme and patterns of brain atrophy assessed in mild cognitive impairment. Sci Rep. 2018;8:1–10.CrossRef Ekman U, Ferreira D, Westman E. The a/T/N biomarker scheme and patterns of brain atrophy assessed in mild cognitive impairment. Sci Rep. 2018;8:1–10.CrossRef
20.
go back to reference Mitchell AJ, Shiri-Feshki M. Rate of progression of mild cognitive impairment to dementia - meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand. 2009;119:252–65.CrossRef Mitchell AJ, Shiri-Feshki M. Rate of progression of mild cognitive impairment to dementia - meta-analysis of 41 robust inception cohort studies. Acta Psychiatr Scand. 2009;119:252–65.CrossRef
21.
go back to reference Vermunt L, Veal CD, ter Meulen L, Chrysostomou C, van der Flier W, Frisoni GB, et al. European prevention of Alzheimer’s dementia registry: recruitment and prescreening approach for a longitudinal cohort and prevention trials. Alzheimers Dement. 2018;14:837–42.CrossRef Vermunt L, Veal CD, ter Meulen L, Chrysostomou C, van der Flier W, Frisoni GB, et al. European prevention of Alzheimer’s dementia registry: recruitment and prescreening approach for a longitudinal cohort and prevention trials. Alzheimers Dement. 2018;14:837–42.CrossRef
22.
go back to reference Bos I, Vos S, Vandenberghe R, Scheltens P, Engelborghs S, Frisoni G, et al. The EMIF-AD multimodal biomarker discovery study: design, methods and cohort characteristics. Alzheimers Res Ther. 2018;10:1–9.CrossRef Bos I, Vos S, Vandenberghe R, Scheltens P, Engelborghs S, Frisoni G, et al. The EMIF-AD multimodal biomarker discovery study: design, methods and cohort characteristics. Alzheimers Res Ther. 2018;10:1–9.CrossRef
23.
go back to reference Jessen F, Spottke A, Boecker H, Brosseron F, Buerger K, Catak C, et al. Design and first baseline data of the DZNE multicenter observational study on predementia Alzheimer’s disease (DELCODE). Alzheimers Res Ther. 2018;10:1–10.CrossRef Jessen F, Spottke A, Boecker H, Brosseron F, Buerger K, Catak C, et al. Design and first baseline data of the DZNE multicenter observational study on predementia Alzheimer’s disease (DELCODE). Alzheimers Res Ther. 2018;10:1–10.CrossRef
24.
go back to reference Mueller SG, Weiner MW, Thal LJ, Petersen RC, Jack C, Jagust W, et al. The Alzheimer’s disease neuroimaging initiative. Neuroimaging Clin N Am. 2005;15:869–77.CrossRef Mueller SG, Weiner MW, Thal LJ, Petersen RC, Jack C, Jagust W, et al. The Alzheimer’s disease neuroimaging initiative. Neuroimaging Clin N Am. 2005;15:869–77.CrossRef
25.
go back to reference Nordlund A, Rolstad S, Klang O, Edman Å, Hansen S, Wallin A. Two-year outcome of MCI subtypes and aetiologies in the Göteborg MCI study. J Neurol Neurosurg Psychiatry. 2010;81:541–6.CrossRef Nordlund A, Rolstad S, Klang O, Edman Å, Hansen S, Wallin A. Two-year outcome of MCI subtypes and aetiologies in the Göteborg MCI study. J Neurol Neurosurg Psychiatry. 2010;81:541–6.CrossRef
27.
go back to reference World health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. 1992. World health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. 1992.
28.
go back to reference Religa D, Fereshtehnejad S-M, Cermakova P, Edlund A-K, Garcia-Ptacek S, Granqvist N, et al. SveDem, the Swedish dementia registry – a tool for improving the quality of diagnostics, Treatment and Care of Dementia Patients in Clinical Practice. PLoS One. 2015;10:e0116538.CrossRef Religa D, Fereshtehnejad S-M, Cermakova P, Edlund A-K, Garcia-Ptacek S, Granqvist N, et al. SveDem, the Swedish dementia registry – a tool for improving the quality of diagnostics, Treatment and Care of Dementia Patients in Clinical Practice. PLoS One. 2015;10:e0116538.CrossRef
29.
go back to reference Schmidt M. Rey auditory verbal learning test: a handbook. Western Psychological Services; 1996. Schmidt M. Rey auditory verbal learning test: a handbook. Western Psychological Services; 1996.
30.
go back to reference Meyers J, KR M. Rey complex figure test and recognition trial. In: Psychological Assessment Resources; 1995. Meyers J, KR M. Rey complex figure test and recognition trial. In: Psychological Assessment Resources; 1995.
31.
go back to reference Delis D, Kaplan E, Kramer J. The Delis-Kaplan executive function system: examiner’s manual. In: The Psychological Corporation; 2001. Delis D, Kaplan E, Kramer J. The Delis-Kaplan executive function system: examiner’s manual. In: The Psychological Corporation; 2001.
32.
go back to reference Wechsler D. Wechsler Adult Intelligence Scale- Fourth Edition: Technical and interpretive manual. 4th. San Antonio: Pearson; 2008. Wechsler D. Wechsler Adult Intelligence Scale- Fourth Edition: Technical and interpretive manual. 4th. San Antonio: Pearson; 2008.
33.
go back to reference Kaplan E, Goodglass H, Weintraub. Boston Naming Test. Philadelphia: Lea & Febiger; 1983. Kaplan E, Goodglass H, Weintraub. Boston Naming Test. Philadelphia: Lea & Febiger; 1983.
34.
go back to reference Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, et al. Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry. 1992;55:967–72.CrossRef Scheltens P, Leys D, Barkhof F, Huglo D, Weinstein HC, Vermersch P, et al. Atrophy of medial temporal lobes on MRI in “probable” Alzheimer’s disease and normal ageing: diagnostic value and neuropsychological correlates. J Neurol Neurosurg Psychiatry. 1992;55:967–72.CrossRef
35.
go back to reference Scheltens P, Pasquier F, Weerts J, Barkhof F. Qualitative assessment of cerebral atrophy on MRI: inter-and intra-observer reproducibility in dementia and normal aging. Eur Neurol. 1997;37:95–9.CrossRef Scheltens P, Pasquier F, Weerts J, Barkhof F. Qualitative assessment of cerebral atrophy on MRI: inter-and intra-observer reproducibility in dementia and normal aging. Eur Neurol. 1997;37:95–9.CrossRef
36.
go back to reference Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjögren M, et al. A new rating scale for age-related white matter changes. Stroke. 2001;32:1318–22.CrossRef Wahlund LO, Barkhof F, Fazekas F, Bronge L, Augustin M, Sjögren M, et al. A new rating scale for age-related white matter changes. Stroke. 2001;32:1318–22.CrossRef
37.
go back to reference Muehlboeck J-S, Westman E, Simmons A. TheHiveDB image data management and analysis framework. Front Neuroinform. 2014;7:1–13.CrossRef Muehlboeck J-S, Westman E, Simmons A. TheHiveDB image data management and analysis framework. Front Neuroinform. 2014;7:1–13.CrossRef
38.
go back to reference Simmons A, Westman E, Muehlboeck S, Mecocci P, Vellas B, Tsolaki M, et al. The AddNeuroMed framework for multi-Centre MRI assessment of Alzheimer’s disease: experience from the first 24 months. Int J Geriatr Psychiatry. 2011;26:75–82.CrossRef Simmons A, Westman E, Muehlboeck S, Mecocci P, Vellas B, Tsolaki M, et al. The AddNeuroMed framework for multi-Centre MRI assessment of Alzheimer’s disease: experience from the first 24 months. Int J Geriatr Psychiatry. 2011;26:75–82.CrossRef
Metadata
Title
The MemClin project: a prospective multi memory clinics study targeting early stages of cognitive impairment
Authors
Urban Ekman
Daniel Ferreira
J-Sebastian Muehlboeck
John Wallert
Anna Rennie
Maria Eriksdotter
Lars-Olof Wahlund
Eric Westman
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-1478-3

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