The MOPEAD project: Advancing patient engagement for the detection of “hidden” undiagnosed cases of Alzheimer's disease in the community

Abstract

In most, if not all health systems, dementia is underdiagnosed, and when diagnosis occurs, it is typically at a relatively late stage in the disease process despite mounting evidence showing that a timely diagnosis would result in numerous benefits for patients, families, and society. Moving toward earlier diagnoses in Alzheimer's disease (AD) requires a conscientious and collective effort to implement a global strategy addressing the multiple causes hindering patient engagement at different levels of society. This article describes the design of the Models of Patient Engagement for Alzheimer's Disease project, an ongoing EU‐funded public‐private multinational initiative that will compare four innovative patient engagement strategies across five European countries regarding their ability to identify individuals with prodromal AD and mild AD dementia, which are “hidden” in their communities and traditionally not found in the typical memory clinic setting. The strategies include an online AD citizen science platform, an open house initiative at the memory clinics, and patient engagement at primary care and diabetologist clinics.

Clinical Applicability of the Specific Risk Score of Dementia in Type 2 Diabetes in the Identification of Patients with Early Cognitive Impairment: Results of the MOPEAD Study in Spain

“…A total of 39 T2D were evaluated at the memory clinic and underwent a complete neuropsychological assessment, as previously described [ 13 ], and 34 individuals (87.2%) received a diagnosis of MCI, 3 (7.7%) of AD dementia and 2 (5.1%) of cognitively healthy. Table 2 reflects the characteristics of these patients.…”

“…One limitation of our study is the small sample size (as per protocol 100 patients/country [ 13 ]) and the fact that most of the patients that met criteria for referral to the memory clinic declined further participation in the study due to associated comorbidities and lack of interest. This observation deserves a comment: The study of cognitive status is not a current priority for the patients and health care providers.…”

“…In each country, at least 100 patients were to be screened/model in order to refer at least 33 patients to the memory clinic/model. The four different models were called “Runs”, as follows: (a) Run 1: AD Citizen Science, on-line screening campaign; (b) Run 2: Open House campaign; (c) Run 3: Primary care based patient engagement; (d) Run 4: Tertiary care based patient engagement The extended protocol was previously published and explained [ 13 ].…”

“…During the visit, all the patients were asked up to three initial questions about their cognitive state: (1) “Do you feel that your memory is getting worse?” (2) “How long have you been noticing it?” and (3) “Are you worried about this alteration?” Additionally, a hypoglycemia survey was created for the MOPEAD protocol in order to evaluate the presence, the number and severity of hypoglycemia (see Supplementary Material ). As per MOPEAD protocol, [ 13 ] those subjects having a MMSE score ≤ 27 or DSDRS ≥ 7 and positive answer for ≥ 2 of the initial questions or DSDRS ≥ 10 were referred to the specialized memory clinic (Fundació ACE, Barcelona, Spain) to complete the neuropsychological evaluation.…”

“…Additionally, a hypoglycemia survey was created for the MOPEAD protocol in order to evaluate the presence, the number and severity of hypoglycemia (see Supplementary Material). As per MOPEAD protocol, [13] those subjects having a MMSE score ≤ 27 or DSDRS ≥ 7 and positive answer for ≥ 2 of the initial questions or DSDRS ≥ 10 were referred to the specialized memory clinic (Fundació ACE, Barcelona, Spain) to complete the neuropsychological evaluation.…”