Blood Biomarkers to Detect Alzheimer Disease

To the Editor In their excellent research, Dr Palmqvist and colleagues report high diagnostic accuracy of blood biomarkers in the diagnosis of Alzheimer disease. The authors used the STROBE checklist for observational studies, but this is a prospective diagnostic accuracy study, for which the STARD checklist is more appropriate.

Read More

Resilience-promoting social networks among unpaid dementia caregivers: protocol for a mixed-methods, 2-year exploratory study

Introduction
Unpaid caregivers of people living with dementia often experience lower levels of perceived life satisfaction and higher rates of depression and anxiety compared with those caring for individuals without Alzheimer’s disease or related dementias. While research on unpaid caregiver well-being and satisfaction has primarily focused on the characteristics of people living with dementia and their dyadic relationships, it has not adequately explored the role of social networks in supporting unpaid caregiver well-being. In this study, we aim to fill this gap by taking an egocentric social network approach to understand the multiple dimensions of social relations among unpaid caregivers of people living with Alzheimer’s disease or related dementia.

Methods and analysis
We will conduct a mixed-method, 2-year exploratory study that involves a structured survey-based telephone interview in year 1 and semistructured interviews in year 2 with caregivers of PLWD recruited through community and healthcare partners. Participants will participate in 1 60-min interview in year 1 (n=100) and a 45–60 min semistructured interview in year 2 (n=75). Eligibility for caregivers includes being an unpaid caregiver, aged 40 years or older, residing and providing care in Arizona or Nevada. The survey consists of questions about caregiver and care recipient demographics, caregiver background, caregiver stress, resilience, well-being and egocentric social network data. Network composition attributes, such as tie strength, the function of the relationship and reliance on network members, will also be assessed. In year 2, qualitative semistructured interviews will supplement these quantitative measures to understand network selection, perceived network changes over time and network strength.

Ethics and dissemination
The Arizona State Institutional Review Board (00018191) approved this study. All participants will receive electronic informed consent documents to review and sign. During the initial interview, participants will be asked if they have any questions about the informed consent documents. We will confirm that participants have completed the required consent form before the start of any research activity. The findings of this study will be disseminated through peer-reviewed journal articles, academic and community presentations, and community-focused publications targeting caregivers.

Read More

Regional variations in healthcare in people living with dementia in Germany: protocol for a mixed-methods study

Introduction
Care for people living with dementia is both important and complex, and there is evidence of large regional variations in the quality of care. This study protocol describes design, methods and objectives of an investigation of regional variations in the utilisation, the quality and the costs of care for people living with dementia in Germany.

Methods and analysis
An exploratory, naturalistic, mixed-methods study is being conducted with three modules: Module A: A quantitative analysis of claims data of statutory health insurance will be conducted to investigate regional variations in the utilisation and costs of care. Module B: In selected regions of interest that deviate significantly from the average in terms of utilisation in Module A, the quality of care and patient characteristics, variations and possible causes of these variations in care will be examined in more detail using quantitative and qualitative assessments. Module C: The claims and primary data from modules A and B will be combined, synthesised and evaluated to elicit recommendations for regional healthcare using a participatory consensus method.

Ethics and dissemination
The study is overseen by the German Alzheimer’s Association. The study’s ethics and data protection plan was approved by the data and ethics committee of the leading university, Brandenburg Medical School Theodor Fontane (reference number: 152092023-BO-E) as well as the data committee of the three participating health insurances. Dissemination plans include dissemination of our main results to the general public, people affected, the scientific community and funding-, policy- and decision makers. Study outcomes and conclusions will be published on our own and the funder’s websites, through presentations at conferences and in scientific journals. The funder ensures dissemination of main study results and recommendations for action to relevant organisations and institutions. Publication of the study’s main results is planned within 6 months of the study’s conclusion.

Trial registration number
DRKS00031944 (https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00031944).

Read More