New Oxford project aiming to improve Alzheimer's diagnosis

The initiative will pilot a clinical pathway for the diagnosis of Alzheimer's disease, including biomarker assessment via cerebrospinal fluid.

If successful, this could be implemented across other NHS Trusts.

Biomarkers are measurable changes in the body that help to identify and monitor disease processes or responses to treatments.

They are present in blood, other body fluids, including cerebrospinal fluid, organs, and tissues.

The National Institute on Aging–Alzheimer’s Association has recently recommended cerebrospinal fluid biomarker testing to complement existing diagnostics.

The hope is this will improve the accuracy of an Alzheimer's disease diagnosis and enable staging of the disease.

Most NHS memory clinics do not have access to the resources needed to offer cerebrospinal fluid biomarker testing, especially those based in mental health trusts.

The project aims to address this issue and validate the processes for building capacity for biomarker testing in NHS mental health trust-based memory clinics nationally.

Cerebrospinal fluid testing capacity will be developed at the Oxford Health Clinical Research Facility and three other UK sites, acting as a pilot for future implementation of the service.

The project aims to improve diagnostic accuracy of dementias including Alzheimer's disease, validate the benefits of early diagnosis, understand what is required to deliver cerebrospinal fluid testing in memory clinics, and develop a case to commission cerebrospinal fluid testing.

Lead researcher director of research and development at Oxford Health, Professor Vanessa Raymont, said: “This type of project enables us to develop and deliver the best service we can for people attending memory clinics."

Professor Vanessa Raymont is also associate director of Dementias Platform UK, which is running the project (Image: Marr Sarah/Oxford Health) The biomarker project is a multi-site pilot programme across four NHS mental health trusts.

These sites, in Manchester, Brighton, Sheffield, and Oxford, service diverse socio-economic and ethnic populations.

This is key for establishing the utility of generalisable biomarker testing across all people visiting NHS memory clinics.

Each site involved in the study will recruit approximately 100 participants deemed to benefit from the testing by an attending clinician after an initial referral and diagnostic scan.

Each of the participants will be scheduled for a lumbar puncture for cerebrospinal fluid extraction and testing.

Once processed, results will be provided to patients via their memory clinic doctor.

Comparisons to initial diagnoses with those reached following the testing to assess diagnostic accuracy will then be made.

This information, together with other patient data collected throughout the project, will validate the utility, feasibility, and health economic benefit of cerebrospinal fluid testing.

It will be fed back to the NHS to determine whether more sites should be equipped to provide this service nationally.