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Background: Dilated perivascular spaces (DPVS) has been hypothesized to be implicated in the development and/or progression Alzheimer's disease (AD). However, evidence of a relationship between its topographic distribution and burden of AD pathologies has not been well‐established. We thus aimed to evaluate whether beta‐amyloid (Aβ) and tau burdens measured in positron emission tomography (PET) are associated with topographic distribution of DPVS. Method: Fifty‐one patients with amnestic mild cognitive impairment or mild dementia due to possible AD were recruited. Aβ burden was measured as Centiloid (CL) scale from 18F‐florbetaben PET. Burden of tau on regions comprising Braak stage III‐IV of neurofibrillary pathology (Braak H, et al. 2006) was measured as standardized uptake value ratio (SUVR) from tau tracer PI‐2620 PET. DPVS were assessed in the basal ganglia (BG‐DPVS) and in the subcortical white matter (WM‐DPVS) in T1‐sequences of brain MRI. DPVS severities were rated by an established 4‐point semiquantitative score and were then classified as high degree (score>2) or low degree (score≤2) (Martinez‐Ramirez, et al. 2013). The patients were further categorized into 3 groups including patients with higher, equal, and lower score of BG‐DPVS compared to WM‐DPVS (BG>WM, BG = WM, and BGWM (n = 20), BG = WM (n = 13), and BG

Background: There is a lack of epidemiological knowledge about whether individuals with dementia receive the same quality of diagnostics and treatment. Method: We explored the ICD10 National Health Security Office (NHSO) in‐patient record of dementia in Thailand. We analyzed the prevalence, etiologies, regional distribution, and outcome of dementia in Thailand during 2015‐2019. We reviewed a cross‐sectional cohort study based on data from the NHSO. Result: Studied in‐patients diagnosed with dementia between 2015 and 2019 (n = 29,895; 40,981 visits) 17,058(57.1%) were female. 3,665(12.3%); 11,638(38.9%); 8,845(29.6%); 1,814(6.1%); 1,418(4.7%); and 2,515(8.4%) were in the northern, central, northeast, eastern, western, and southern part of Thailand respectively. Among 29,895 dementia cases, 15.4%, 18.7%, 20.2%, 24.1%, and 21.6% were prevalence cases in 2015, 2016, 2017, 2018, and 2019 (registered up to 30th September where was the end of fiscal year) respectively. 16.1% were single, 68.5% were married, 6.6% were divorced, and 8.9% had other marital status. 85% aged 65 and over. Mean age of these cohort was 75.42(sd = 11.97) years old. The etiologies registered as dementia were as followed: 9.3% had AD, 0.2% had bvFTD, 9.3% ha VaD, 2.1% had other degenerative dementia, 77.4% ha unspecified dementia, and 1.8% had cognitive impairment due to metabolic and physiological condition. During these 5 years, 59.3% were dead. Mean duration of admission were 9.84(sd = 19.84) days. Mean cost of expense during admission were 31,521.79(sd = 80,647.68) Baht. Conclusion: The dementia registry offers the surrogate clinical best practice and patient outcomes. The importance and significance in having dementia data cannot be undervalued. [ABSTRACT FROM AUTHOR]

Introduction: Plasma phosphorylated tau (p-tau)217 is a promising biomarker for Alzheimer's disease (AD) diagnosis, but its clinical implementation remains challenging. We propose a strategy based on Bayes' theorem and test it in real-life memory clinics., Methods: Memory clinic patients were evaluated by neurocognitive specialists for prespecified diagnosis and subsequently underwent blood collection for p-tau217, cerebrospinal fluid, or amyloid positron emission tomography. Using cross-validation, the Bayesian approach (pretest probability × individualized likelihood ratio) was compared to other models for AD diagnosis., Results: The Bayesian strategy demonstrated an area under the receiver operating characteristic curve (AUC) of 0.98 (95% confidence interval [CI]: 0.96-1.0), significantly outperforming multivariable logistic regression (p-tau217, age, apolipoprotein E; AUC 0.95, p = 0.024) and p-tau217 alone (AUC = 0.94, p = 0.007). When applying the two-threshold approach, the Bayesian strategy yielded an accuracy of 0.94 (95% CI: 0.88-1.0) without requiring confirmatory tests in 62.9% of the iterations., Discussion: The Bayesian strategy offers an effective and flexible approach to address the limitations of plasma p-tau217 in clinical practice., Highlights: Incorporating pretest probability into the interpretation of plasma phosphorylated tau (p-tau)217 improves the diagnostic performance significantly. The strategy could obviate the need for confirmatory testing in most of the patients. Plasma p-tau217 proves useful as a biomarker for Alzheimer's disease in low- and middle-income country such as Thailand., (© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)