Alzheimer's disease is characterised by the formation of so-called amyloid plaques in the brain. These protein accumulations disrupt brain functions and can lead to memory problems and dementia. While memory problems are often the first sign of Alzheimer's disease, not everyone develops this symptom. Memory tests and a brain scan can be used to determine the risk of developing dementia. However, it is still relatively common for these tests to provide no definitive diagnosis. As a result, patients are unsure of where they stand, which can impact quality of life.

Puncture
Measuring proteins in cerebrospinal fluid can help to improve dementia predictions. A lumbar puncture is performed to remove cerebrospinal fluid is removed from the spinal cord. This fluid is then examined for abnormalities in the amount of Alzheimer proteins. However, this technique is not widely used, given that its effectiveness has yet to be sufficiently determined. The Maastricht researchers therefore analysed a fictitious scenario using a computer model, in which the lumbar puncture formed a standard part of the diagnostic tests for people with memory problems. During the process, they asked one simple question: does the test add value? In answering this question, they took into account how the test would affect quality of life, health care costs, side effects, and other issues.

Added value
Their findings reveal that the introduction of a lumbar puncture improves the accuracy of predicting future dementia by eleven per cent. While the diagnostic test is associated with higher costs, it was also found to improve quality of life. 'That's what it's all about,' says head researcher Ron Handels. 'If our assumptions are correct, incorporating a lumbar puncture into the standard diagnostic process is probably effective. After having demonstrated its potential, it's valuable to research its effect on quality of life to determine whether lumbar punctures should become standard practice.'