ALZHEIMER EUROPE
MOPEAD: shifting the paradigm to early diagnosis of Alzheimer’s disease Annette Dumas, ASDM Consulting, Communication and Dissemination Work Package Co-Leader, and Mercè Boada, Fundació ACE, MOPEAD Coordinator share the achievements of the MOPEAD (Models Of Patient Engagement for Alzheimer’s Disease) project.
The presence of associated comorbidities was the main factor for declining referral. The results varied between countries. Some countries were more successful in pre-screening (Slovenia, followed by Spain). This can be attributed to having much higher numbers of pre-screened individuals in RUN 1 in these two countries. Overall, more women participated in the pre-screening in all RUNs except for RUN 4. The percentage of individuals eventually diagnosed with MCI or dementia was higher for males in RUNs 1 and 2 while the percentage was higher for women in RUNs 3 and 4. Screening costs
Despite evidence showing that the pathological process of Alzheimer’s disease (AD) starts many years before clinical symptoms appear and evidence about the economic and social value of early detection of AD, people with early AD (mild cognitive impairment (MCI) due to AD and mild AD dementia) remain outside of clinical settings and the diagnosis rates are low.
Five EU countries were represented in the project: Germany, Slovenia, Spain, Sweden and the Netherlands.
The screening cost per True Positive (TP) ranged between EUR 3,115 (RUN 1) and EUR 1,190 (RUN 4) (EUR 2,772 for RUN 2 and EUR Screening results 1,530 for RUN 3). The cost per screened individual ranged between EUR 103 (RUN 1) and For every ten at-risk individuals who were pre- EUR 2,204 (RUN 3) (EUR 212 for RUN 4 and EUR screened during the project, approximately 1,338 for RUN 2). six individuals with MCI due to AD/prodromal AD or dementia were identified. Out of the The cost differences are attributed to the charMOPEAD (Models Of Patient Engagement for 2,847 pre-screened individuals, 972 screened acteristics of the samples: RUNs 1 and 2 aimed Alzheimer’s Disease) is an Innovative Medi- positive and 398 were evaluated. In the end, at the general population (healthy subjects) cines Initiative-funded project contributing 236 received an AD diagnosis. while RUNs 3 and 4 aimed at a population at to the current drive to shift the paradigm to risk with concomitant comorbidities. More early diagnosis of AD. The project responds In Spain, RUN 4 found a high prevalence of subjects need to be tested in RUNs 1 and 2. to the global community’s work towards the unknown cognitive impairment in T2DM 2025 dementia goals articulated around four patients. The Diabetes Specific Dementia Risk There were big country-associated differences key areas: finding a disease-modifying ther- Score was found to be a useful screening tool. regarding the screening costs. RUNs 3 and 4 apy, living well with dementia, better care, and reducing the impact of dementia. An innovative project MOPEAD has been innovative in the sense that it has tested patient engagement models that have until now received little attention: two whereby citizens actively sought out a cognitive test: (RUN 1) Citizen Science – an online pre-screening tool, (RUN 2) Open House – pre-screening tests performed in a memory clinic without a physician’s referral, and two strategies testing patients at risk: (RUN 3) in primary care settings and (RUN 4) in type 2-diabetes / T2DM specialist settings. The persons identified to be at risk of AD were offered referral to a memory clinic for a full diagnostic assessment that they were free to accept or refuse. 14 Dementia in Europe
MOPEAD Consortium meeting, Berlin, October 2017
