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P1‐173: IDEOMOTOR LIMB APRAXIA IN INDIVIDUALS WITH ALZHEIMER'S DISEASE DEMENTIA (ILIAD)
Author(s) -
ElRuwie Nezar,
Soulsby William Daniel,
Anderson Katelyn,
Gatla Shravan,
Najmi Safa,
Krojanker Elan,
Viswambharan Vishal,
Ravi Chaitanya,
Malmstrom Theodore,
Grossberg George
Publication year - 2014
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2014.05.411
Subject(s) - apraxia , dementia , psychology , context (archaeology) , cognition , depression (economics) , disease , clinical psychology , physical medicine and rehabilitation , psychiatry , medicine , aphasia , paleontology , macroeconomics , economics , biology
diagnostic value of 18F-Florbetapir amyloid PET on top of routine assessment in an Italian naturalistic setting. Methods: The study started in Sept 2013 and plans to enroll 250 patients coming to observation of 21 Alzheimer’s Evaluation Unit in Eastern Lombardy, Italy, until Dec-2014. 30 healthy elderly controls (HC) will also be enrolled. Patients will undergo a diagnostic work-up according to usual local practice. Physicians will formulate a clinical diagnosis and rate their diagnostic confidence (range between 15% and 85%). Patients will undergo 18F-Florbetapir PET. Diagnosis, diagnostic confidence and treatment plan will be revised based on 18F-Florbetapir scan results. Results: During the first 5 months, 73 patients and 9 HC were enrolled. Of these, 57 patients completed their diagnostic work-up. Clinical diagnosis were as follows n1⁄415 MCI due to AD; n1⁄4 23 AD; n1⁄43 FTD; n1⁄47 MCI not due to AD; n1⁄49 had other dementias (PDD, DBL, CBS). 56 patients and 8 HC underwent 18F-Florbetapir PET. Negative scans occurred in 18% of AD, 33% of MCI due to AD, 29% of MCI not due to AD, 33% of FTD, 33% of patients with other dementias. Two HC had a positive amyloid-PET scan. To date, the diagnosis was re-evaluated post-amyloid imaging in 40 patients, and 18F-florbetapir results led to a change in diagnosis in 42% of these patients. T he diagnostic confidence increased significantly after amyloid imaging for both confirmed and changed clinical diagnoses (15% and 17% increase in confidence respectively, p<0.0005). Amyloid PET positivity had a significant impact on the therapeutic plans of patients with an initial diagnosis of AD, MCI due to AD or DLB, with an increase of 29% in the prescription of AChE (p1⁄40.01). Conclusions: 18F-Florbetapir PET has a significant impact on diagnosis, diagnostic confidence and treatment plan of dementia experts.