Implementation of regular CSF biomarkers in the memory clinic

<h3>Background</h3> The memory clinic at Sheffield Teaching Hospital, a tertiary centre receives approximately 200 referrals annually, has not previously used cerebrospinal fluid (CSF) biomarker analysis regularly, and has predominantly relied on clinical assessment, neuropsychology evaluation, and neuroimaging. <h3>Methods</h3> This audit assessed the effect of regular CSF biomarker implementation in the memory clinic on diagnostic accuracy, cost savings, time to diagnosis, and treatment. <h3>Results</h3> 47 participants (51–80 years old, 62% males) referred to the memory clinic were included. Twenty-five (53%) patients were given a provisional diagnosis of AD. 85% of referred patients were positive for at least one CSF biomarker. Biomarker implementation reduced the average time to treatment by 1.7 years (138%) (p &lt;0.003) and diagnosis by 33 weeks (76%) (p &lt;0.08) whilst reducing the average number of investigations by 60% (p&lt; 0.001) and appointments by 47% (p&lt;0.0001). The reduction in investigations is estimated to save £10,000 annually. <h3>Conclusions</h3> The use of CSF AD biomarker analysis has significantly improved the efficiency of our memory clinic, with a considerable reduction in times to diagnosis and treatment. Regular and dedicated lumbar puncture clinics with appropriate staffing will ensure that biomarker analyses can be performed at an optimum rate.