Using cerebrospinal fluid biomarkers to diagnose Alzheimer’s disease: an Australian perspective
Cerebrospinal fluid (CSF) biomarkers are currently the only clinically validated biofluid diagnostic test for Alzheimer’s Disease (AD) available in Australia. Despite CSF analysis being a safe and cost-effective diagnostic method, the use of CSF biomarkers in the evaluation of potential AD remains limited in Australian clinical practice due to a variety of factors, including regional access challenges, concerns over the perceived invasiveness of lumbar puncture and a lack of confidence among clinicians in interpreting the results.
This paper provides expert guidance on the broader adoption of CSF biomarker testing by providing evidence-based, clinically informed expert guidance on when and why to consider CSF biomarker testing.
The educational roadshow series held in Sydney, Brisbane, Melbourne, and Perth featured a panel of dedicated keynote speakers passionate about improving outcomes for Alzheimer’s Disease patients in Australia. Hear perspectives covering the importance of accurate early diagnosis, Australia's changing Alzheimer's Disease landscape, updates on patient management, new clinical pathways and evolving models of care.
Learn more from our distinguished panel of speakers below:
Did you know that it is estimated that approximately 40% of dementia cases can be prevented by modifiable risk factors?1 Assoc. Prof. Woodward explores the characteristics of Mild Cognitive Impairment (MCI), outlining who goes on to develop dementia, and how we can extend our brain health for as long as possible.
We lose 1% of volume of our brain each year2, which is normal ageing but does it follow that cognitive decline inevitable? Multiple risk factors of MCI progressing to dementia include depression, hypertension, diabetes, hypercholesterolemnia, and obesity. So which risk factors can we modify and which ones can’t we change?
For further details download the WHO Guidelines for Risk reduction of cognitive decline and dementia. In addition, the first-ever Australian dementia clinical guideline for clinical professionals with a guided consumer version is now available.
A/Prof. Michael Woodward
Assoc. Prof. Michael Woodward is currently Director and Clinical Head of Aged Care Research, Heidelberg Repatriation Hospital, Austin Health; Director, Memory Clinic Director, Chronic Wound Management Clinic, Austin Health.
It is estimated that over 1 trillion USD has been spent to get to where we are now in terms of diagnosis and treatment of Alzheimer’s Disease. It is a pivotal time in the research of Alzheimer’s Disease as the steps are now all coming together.
Prof. Masters has worked on Amyloid Plaques for over 50 years developing the Amyloid Beta Theory on the Etiology of Alzheimer’s Disease but believes we have further to go
The diagnosis process at the Florey Institute in Melbourne uses Cerebrospinal fluid (CSF) and blood biomarkers in conjunction with PET scans; and plans are underway for this testing to become available in all capital cities in Australia. The progress in approved testing has many companies competing in this revolutionary area but accurate and early diagnosis is key.
Prof. Colin Masters
Prof. Colin Masters is a Professor of Dementia Research at the Florey Institute of Neuroscience and Mental Health, University of Melbourne and a consultant at the Royal Melbourne Hospital. Prof. Masters has focused his career on research in Alzheimer’s disease and other neurodegenerative diseases, including Creutzfeldt-Jakob disease.
How to communicate a diagnosis and manage dementia holistically
The evidence is clear – living positively with dementia is possible. The key is early diagnosis, followed closely by post diagnostic support.
The four pillars of giving the diagnosis – communication, compassion, hope and follow up covered in ‘Forward with dementia’ – a guide to living with dementia is discussed by Prof. Brodaty in this session.
You can also review the National Institute for Health and Care Excellence (NICE) Guideline [NG97] - Dementia: assessment, management and support for people living with dementia and their carers. For additional information please visit the Dementia Australia website.
Prof. Henry Brodaty
Prof. Henry Brodaty is a researcher, clinician, policy advisor and strong advocate for people with dementia and their carers. At UNSW Sydney, he is Scientia Professor of Ageing and Mental Health, and Co-Director of the Centre for Healthy Brain Ageing.
Dementia is currently the leading cause of death in Australia and the number of those living with dementia in Australia is estimated to be over 849,000 by 2058.3 With this in mind, Dr. Pulle discusses the impact this will have and evolving landscape for management. While no two dementia experiences are the same they will most likely all require the same touch points throughout – primary care, medical specialists, aged care system, community/social support, palliative care and the hospital system.
Are we ready for the next generation clinical pathway for Alzheimer’s Disease? Is the future public or private? What trials are available?
You can also find out more about the Australian Government's National Dementia Plan to see where we are now and what’s next!
Dr. Chrys Pulle
Dr. Chrys Pulle is currently working in a clinical capacity as a Senior Staff Specialist / Geriatrician at The Prince Charles Hospital. He also a Principal Investigator at The Prince Charles Hospital Internal Medicine and Dementia Research Unit.
Are we ready for the new diagnostics and amyloid antibody therapies for Alzheimer’s Disease?
Prof. Rowe presents a practical overview on what’s available presently in terms of access to biomarkers, what’s coming in the near future. Discover what diagnostics are available and where to get them, the most recent developments for treatments, the prerequisites for receiving these treatments, and what you can expect in terms of benefits.
Critical questions remain but the clear need for early detection is vital – as early intervention has shown the greatest evidence of benefit in treatment studies.
Are we ready for amyloid monoclonal antibody therapy - discover more about new therapies and the available dementia trials.
Prof. Chris Rowe
Prof. Christopher Rowe is a neurologist and nuclear medicine specialist at Austin Health and a Professor of the University of Melbourne, Australia. He has been the imaging leader of the AIBL study since 2006 and is the Director of the Australian Dementia Network (ADNeT), a national collaboration of 15 universities and research institute.
What is the current state of play regarding Alzheimer’s drugs? Critical questions include: Do they work? What are the side effects? What is the cost? What are the alternatives?
The presentation explores anti amyloid drugs which all target different parts of the amyloid molecule but explains that the clinical results have been varied. What is the relationship between amyloid and cognition? What is the role of tau?
New drugs are about to be approved by the TGA and all neurologists, geriatricians and anyone who works with people in dementia will need to know about them.
Dr. Carolyn Orr
Dr. Carolyn Orr is a consultant neurologist who originally trained in medicine at the University of Glasgow. She holds a PhD in Parkinson’s disease from UNSW, and did her fellowships in Movement Disorders and Behavioural Neurology at the Mayo Clinic.
Q&A
Why is this meeting important and what is changing in the landscape of Alzheimers Disease in Australia?
‘It’s important that specialists better understand that we have biomarkers that define Alzheimer’s and other cognitive disorders much more accurately. It’s very important that we differentiate the early stages from the later stages clinically.. I think it’s most important that we get the diagnosis accurate.’ - A/Prof. Michael Woodward
How can we improve early detection and diagnosis for Alzheimer's Disease?
‘We’re at a pivotal point of applying new technologies for using biofluid analysis, that’s blood and cerebralspinal fluid and also new molecular imaging techniques. Now these new techniques will allow us to diagnose specifically Alzheimer’s Disease at the very earliest stages before the onset of any cognitive impairment. And that means we’ll be able to treat very early.’ - Prof. Colin Masters
How can the diagnostic capacity for Alzheimer's Disease be improved in Australia?
‘Bring in the blood test, I think it’s going to be revolutionary not only in specialist centres but also in primary care. These tests are 90% or more accurate for Alzheimer’s disease. That’s better than expert clinical diagnosis.’ – Prof. Christopher Rowe
Timely diagnosis of Alzheimer's disease is within your reach - please find a range of brochues and factsheets via the link below.
For further information on CSF testing within Australia please contact:
Dr. Margaret Janu
Clinical Stream Lead, Chemical Pathology
NSW Health Pathology
Concord Hospital Diagnostic Pathology Unit
Phone: +61 2 9767 6663
Enquiries: [email protected]
?scl=1)
National Dementia Diagnostics Laboratory
A/Prof Qiao-Xin Li, PhD
Principal Research Fellow
Florey Institute, the University of Melbourne
Phone: +61 3 9035 7243
Mobile: 0407 319 667
Enquiries: [email protected]
Website: florey.edu.au/national-dementia-diagnostics-laboratory
