Introduction The Alzheimer’s Disease Knowledge Scale (ADKS) is one of the most popular instruments for assessing a person’s knowledge regarding Alzheimer’s disease (AD). The objective of this study was to explore ADKS item characteristics with item response theory (IRT) procedures. Methods A noninterventional web-based study was conducted. A nonparametric IRT procedure, Mokken analysis, was used to explore the underlying latent structure of the ADKS and ADKS item characteristics regarding scalability and violations of the monotone homogeneity (MH) model. A random-effects meta-analysis was implemented that combined ADKS scores from independent studies. Results A total of 447 employees of a pharmaceutical company participated in the study. The mean ADKS score was 21.2 (SD 2.8). Mokken analysis showed that most ADKS items (22 of 30) do not fit to any scale and can be considered to be scale independent. Two items (#1: particularly prone to depression; #20: depression can be mistaken for AD) fit to a domain relating to depression, another two items (#2: mental exercise can prevent AD development; #8: benefit of psychotherapy) can be related to potential prevention and improvement, and four items (#12: poor nutrition can make the symptoms worse; #18: high cholesterol may increase the risk of AD; #26: high blood pressure may increase the risk of AD; #27: genes can only partially account for AD development) fit to a risk factor domain. As expected from those results, neither the overall scale (H = 0.033) nor its items showed appropriate scalability index values, suggesting that ADKS does not fit to a MH model. Eleven items showed violations of the assumptions of the MH model. The meta-analytical average score was 21.78 (95% CI 20.67–22.90), with healthcare professionals and caregivers showing the highest levels of AD knowledge. Conclusion Although the ADKS does not present a unidimensional structure, its independent items together provide a comprehensive spectrum of information regarding AD knowledge.

Background: Raising knowledge about Alzheimer’s disease (AD) may help in identifying the disorder, seeking earlier appropriate healthcare, and decreasing its stigma. The aim of this study was to determine the knowledge and perceptions towards people with AD among employees of a pharmaceutical company in Spain. Methods: A non-interventional, cross-sectional study was conducted among 447 employees. Participants answered demographic questions and completed the Alzheimer’s Disease Knowledge Scale (ADKS). Caregivers also answered questions related to their personal experience with patients with AD and completed the Satisfaction with Life Scale (SWLS), the Revised Memory and Behavior Problems Checklist (RMBPC), and the Beck Depression Inventory-Fast Screen (BDI-FS). Results: Participants were mostly between 30 and 50 years old (63%), female (65.3%), and had bachelor or master degrees (82.7%). Forty-two (9.4%) of participants were caregivers, mainly of moderate to severe dementia subjects. Overall knowledge about AD was moderate (mean ADKS score = 21.2 ± 2.8 [70.6% of correct answers]). Risk factors and caregiving were the domains with lowest scores (correct answers: 58.58% and 63%, respectively). Mean total ADKS score was significantly higher in participants caring for people with AD compared with non-caregivers (22.1 ± 2.9 and 21.0 ± 2.8; p=0.02, respectively). There was no statistically significant association between total ADKS score and age, sex, educational level, or relative’s AD severity. Most caregivers were satisfied with life (mean SWLS score = 26.8 ± 5.6) showing a low impact from behavioral problems (mean RMBPC reaction score = 26.81 ± 20.2). Six of them (14.3%) were scored as depressed. Conclusion: There is a continuing need to improve understanding of AD to fill the gaps in knowledge of the disease, even in a population working in healthcare sector with a high educational level.

Introduction: Hospital pharmacists are increasingly playing a critical role in the care of patients with multiple sclerosis (MS). However, little is known about their preferences and perspectives towards different attributes of disease-modifying therapies (DMTs). The objective of this research was to assess pharmacists´ preferences for DMT efficacy attributes. Methods: A multicenter, non-interventional, cross-sectional, web-based study was conducted. Preventing relapses, delaying disease progression, controlling radiological activity, and preserving health-related quality of life (HRQoL) and cognition were the attributes selected based on a literature review and a focus group with six hospital pharmacists. Conjoint analysis was used to determine preferences in eight hypothetical treatment scenarios, combining different levels of each attribute and ranking them from most to least preferred. Results: Sixty-five hospital pharmacists completed the study (mean age: 43.5 ± 7.8 years, 63.1% female, mean years of professional experience: 16.1 ± 7.4 years). Participants placed the greatest preference on delaying disease progression (35.7%) and preserving HRQoL (21.6%) and cognition (21.6%). Importance was consistent in all groups of pharmacists stratified according to demographic characteristics, experience, research background, and volume of patients seen per year. Conclusions: Understanding which treatment characteristics are meaningful to hospital pharmacists may help to enhance their synergistic role in the multidisciplinary management of patients with MS.

The aim of this non-interventional, case–control pilot study was to identify factors associated with cognitive impairment, dementia, and Alzheimer’s disease (AD) using a real-world dataset from Quirónsaludmadrid’s database. Based on Global Deterioration Scale score, 4 models of regression aimed to predict cognitive impairment and dementia (model 1), mild cognitive impairment (MCI, model 2), AD (model 3) and progression (model 4) were created. Age [odds ratio (OR) = 1.721], apathy (OR = 34.952), anxiety (OR = 0.223) and higher education (OR = 0.026) were associated with model 1 with an area under the curve (AUC) of 0.796 and a sensitivity of 0.60 and specificity of 0.86. For model 2, the selected variables were: age (OR = 1.222), apathy (OR = 2.650), depression (OR = 0.318) and higher education (OR = 0.232) with an AUC of 0.657 and a sensitivity of 0.82 and specificity of 0.45. For model 3, variables included were age (OR = 1.490), first-degree family history (OR = 4.147), apathy (OR = 8.247), anxiety (OR = 0.302), and higher education (OR = 0.119) with an AUC of 0.852 and a sensitivity of 0.84 and specificity of 0.73. Model 4 had an AUC of 0.532 and a sensitivity of 0.59 and specificity of 0.65. In conclusion, age and apathy were risk factors for the development of cognitive impairment, MCI and AD, while high education level was a protective factor in the three main models. Family history of dementia was a risk factor for developing AD. Models 3 and 1 had the best selection capacity and could be recommended to predict the diagnosis of AD and cognitive impairment and dementia in individuals with suspicious symptoms or presymptomatic.

Background: Cognitive impairment has an impact upon the function and quality of life of patients with multiple sclerosis (MS). High-serum neurofilament light-chain (sNfL) levels predict disease progression and are also associated with impaired cognitive performance. This study aimed to assess the attitudes of neurologists toward sNfL testing as regards making therapeutic decisions in clinically and radiologically stable patients experiencing cognitive decline. Methods: A web-based observational study was conducted among neurologists caring for patients with MS. The role of sNfL in therapeutic decisions was assessed through a simulated case scenario describing a 31-year-old woman with relapsing–remitting MS for four years on glatiramer acetate. Her partner reported increased distractibility and difficulties in organizing daily activities over the past 18 months. There was no history of new relapses, and a follow-up brain MRI scan showed no new lesions. Her performance in the Symbol Digit Modalities Test decreased by 8 points from the previous year, with 46 correct answers. The patient had an sNfL level of 21 pg/mL, with no other identified factors that could have altered this value. The participants were tasked with deciding to either escalate treatment or to continue the current treatment and schedule the patient for reassessment in 6–12 months (defined as decisions misaligned with emerging evidence [DMEE]). Multivariate regression analysis was conducted to determine factors associated with DMEE. Results: One hundred and sixteen neurologists participated in the study. Almost 50% of the participants (n = 57) opted not to escalate treatment despite high sNfL levels. This was more common among neurologists not fully dedicated to MS care (60.5% vs. 43.6%). The multivariate analysis showed that being a neurologist not fully dedicated to MS (odds ratio [OR] = 2.35, 95% confidence interval [CI] 1.01–5.50; p = 0.04) and having a poor perception of sNfL benefits (OR = 1.02, 95% CI 1.00–1.04; p = 0.01) were associated with DMEE. Conclusions: Neurologists’ lack of full dedication to MS care and limited perception of sNfL’s clinical utility were key factors associated with suboptimal therapeutic decisions in a simulated case of cognitive decline with elevated sNfL. These findings underscore the need for increased education on the role of sNfL to improve evidence-based decision-making in MS management.

Background: Serum neurofilament light chain (sNfL) is an established biomarker of neuroaxonal damage in multiple sclerosis (MS). Despite its prognostic utility, patient awareness of its clinical application remains poorly characterized. The objective of this study was to assess the acceptance of sNfL monitoring among patients with early-stage relapsing–remitting MS (RRMS) and identify factors predicting their willingness to adopt this tool. Methods: This non-interventional, cross-sectional study was conducted across 16 neuroimmunology clinics. We included RRMS patients with a disease duration of ≤3 years receiving disease-modifying therapy. Acceptance was assessed following a standardized educational tutorial. Multivariable logistic regression was employed to identify predictors of patient acceptance. Results: The study included 144 patients (mean age 37.6 [SD 10.3] years, 69.4% female). Only 19.4% (n = 28) had prior awareness of sNfL. However, after the tutorial, 84.0% (n = 121) expressed willingness to adopt sNfL testing. Furthermore, 62.5% (n = 90) indicated that normal sNfL levels would provide emotional reassurance between clinical visits. Patients willing to undergo testing showed higher disease knowledge, less treatment regret, and better physical quality of life and cognitive performance. In the multivariable analysis, higher disease knowledge (OR = 1.52, 95%CI 1.16–1.99; p = 0.002) and lower symptom burden (OR = 0.96, 95%CI 0.93–0.99; p = 0.038) were associated with greater acceptance. Conclusions: Patients demonstrate high receptivity to sNfL monitoring when provided with adequate clinical context. Because disease knowledge is a primary driver of acceptance, personalized educational initiatives may be a complementary strategy to facilitate the integration of precision biomarkers into MS management.