A Bayesian analysis of diagnostic timelines across Alzheimer's disease, frontotemporal dementia, and other neurodegenerative conditions.

IF 4.4 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2025-09-29 eCollection Date: 2025-07-01 DOI:10.1002/dad2.70184

Ananthan Ambikairajah, David Foxe, Ann-Marie G de Lange, James Carrick, Sau Chi Cheung, Velandai K Srikanth, Yun Tae Hwang, Rebekah M Ahmed, James R Burrell, Olivier Piguet

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引用次数: 0

Abstract

Introduction: Timely diagnosis is crucial for managing neurodegenerative conditions. This study investigated whether time from symptom onset to diagnosis differs by clinical syndrome and sex.

Methods: This retrospective, cross-sectional study included 591 participants with Alzheimer's disease (AD), frontotemporal dementia (FTD) subtypes (behavioral variant FTD [bvFTD], semantic dementia [SD], and progressive non-fluent aphasia), logopenic progressive aphasia (LPA), and syndromes associated with movement disorders (corticobasal syndrome, FTD with motor neuron disease [FTD-MND], and progressive supranuclear palsy). Bayesian regression models were used to compute diagnostic timelines.

Results: Compared to AD (3.35 years; 95% credible interval [CrI]: 3.03-3.72), SD and bvFTD had additional delays of 9.7 (95% CrI: 1.96-20.64) and 14.82 months (95% CrI: 6.94-25.42), respectively, while FTD-MND was shorter by 11.62 months (95% CrI: -15.7 to -4.68). Men with bvFTD had 23.64 month longer delays than women (95% CrI: 10.35-44.33).

Discussion: Diagnostic delays may reflect syndrome-specific clinical features, diagnostic complexity, and sociocultural factors. Findings highlight the need for improved diagnostic pathways and pre-clinical biomarkers to facilitate earlier identification.

Highlights: Bayesian analyses revealed that diagnostic delays differ by syndrome and sex.Alzheimer's disease (AD) was diagnosed on average 3.35 years after symptom onset.Diagnoses were delayed in semantic and behavioral variant frontotemporal dementia (bvFTD) compared to AD.Men with bvFTD had longer delays than women.Findings support need for improved diagnostic pathways and pre-clinical biomarkers.

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对阿尔茨海默病、额颞叶痴呆和其他神经退行性疾病的诊断时间线的贝叶斯分析。

及时诊断是至关重要的管理神经退行性疾病。本研究探讨从症状出现到诊断的时间是否因临床证候和性别而异。方法：这项回顾性横断面研究纳入了591名阿尔茨海默病（AD）、额颞叶痴呆（FTD）亚型（行为变异型FTD [bvFTD]、语义性痴呆[SD]和进行性非流畅性失语症）、言语减少进行性失语症（LPA）和与运动障碍相关的综合征（皮质基底综合征、FTD伴运动神经元疾病[FTD- mnd]和进行性核上性麻痹）的参与者。采用贝叶斯回归模型计算诊断时间线。结果：与AD（3.35年，95%可信区间[CrI]: 3.03-3.72）相比，SD和bvFTD分别有额外的9.7个月（95% CrI: 1.96-20.64）和14.82个月（95% CrI: 6.94-25.42），而FTD-MND短11.62个月（95% CrI: -15.7 - -4.68）。男性bvFTD延迟时间比女性长23.64个月（95% CrI: 10.35-44.33）。讨论：诊断延迟可能反映了综合征特异性的临床特征、诊断复杂性和社会文化因素。研究结果强调需要改进诊断途径和临床前生物标志物，以促进早期识别。重点：贝叶斯分析显示诊断延迟因综合征和性别而异。阿尔茨海默病（AD）在症状出现后平均3.35年被诊断出来。与AD相比，语义和行为变异额颞叶痴呆（bvFTD）的诊断延迟。患有bvFTD的男性比女性延迟更长。研究结果支持需要改进诊断途径和临床前生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.