Who are the partners in TAP-dementia?

TAP-dementia is a national partnership comprising ten research institutions and hospitals. The consortium forms part of ZonMw’s Dementia Research Programme.

TAP-dementia stands for Timely, Accurate and Personalised diagnosis of dementia. The consortium is funded by ZonMw, with additional support from Avid Radiopharmaceuticals, Roche Diagnostics, Amprion and the Gieskes-Strijbis Fund.

Who’s who?

Prof. Dr Wiesje van der Flier is the Principal Investigator of TAP-dementia and leads the consortium. The TAP-dementia research is divided into five sub-projects, each with two project leaders.

• TAP-PAT: Dr Inez Ramakers and Prof. Dr Ellen Smets
• TAP-VaMP: Prof. Geert Jan Biessels and Dr Evelien Lemstra
• TAP-TAU: Dr Rik Ossenkoppele and Dr Elsmarieke van de Giessen
• TAP-DANCE: Prof. Dr Meike Vernooij and Dr Esther Bron
• TAP-COPROL: Prof. Dr Charlotte Teunissen and Dr Betty Tijms

Dr Cynthia Hofman (Vilans) is responsible for knowledge management. The research is carried out by a team of PhD students.

Collaborating partners

• Alzheimercentrum Amsterdam, Amsterdam UMC, VUmc site, lead applicant
• Erasmus MC Alzheimer Centre
• Alzheimer Centrum Limburg, Maastricht University
• Radboud UMC Alzheimer Centre
• Alzheimer Centrum Groningen, UMC Groningen
• UMC Utrecht
• Amsterdam UMC, AMC site
• Vrije Universiteit Amsterdam
• Elisabeth-TweeSteden Hospital
• Vilans Knowledge Organisation & Nederlands Geheugenpoli Netwerk

Zonmw.nl: about the Dementia Research Programme.

Diagnosing dementia: earlier and personalised

For many people with dementia, the underlying cause of their dementia is only identified at a late stage – or not at all. TAP-dementia believes this needs to change, as an accurate diagnosis is the foundation for appropriate, personalised care.

TAP-dementia’s research is divided into five so-called sub-projects.

Optimising diagnostic tests for clinical practice

Tests already exist that can detect physical indicators of dementia (biomarkers). Examples include a blood test or a brain scan that can detect Alzheimer’s proteins. Diagnostic tests are also available for other types of dementia. But do these tests work well enough in practice? The TAP-VaMP sub-project, led by TAP-dementia, is investigating this. The consortium aims to use the findings to help doctors make the right choice from among all the available diagnostic tests.

When is the tau scan useful?

There is a scan that highlights brain damage caused by Alzheimer’s disease in colour: the tau scan. Unfortunately, this scan is expensive and not available everywhere. When does such a scan really add value? Who does it benefit, and when might a cheaper test suffice? These are the questions TAP-dementia aims to answer in the TAP-TAU sub-project.

Improving diagnosis with AI

Brain damage visible on scans can sometimes be difficult to assess, particularly when multiple types of damage are present simultaneously. Programmes based on artificial intelligence (AI) may be able to help, assisting in the assessment of the scans. In the TAP-DANCE sub-project, the consortium is investigating whether this is actually possible – and whether it helps to diagnose dementia more quickly and easily.

Identifying new substances that indicate dementia

Cerebrospinal fluid contains all sorts of biomarkers: substances that can indicate brain damage and brain diseases. These can also be measured. Or so we think. But do we actually know all the biomarkers, and can we measure them all? Particularly in the case of complex diseases such as frontotemporal dementia and Lewy body dementia, we may still be missing important biomarkers. TAP-dementia is investigating this in the TAP-COPROL sub-project.

What do the target groups themselves consider important?

The TAP-PAT sub-project focuses on translating research into practice. Every sub-project within this consortium is producing results. But do these results actually meet the needs of people with Alzheimer’s, their loved ones and doctors? What do these target groups consider important? How can they discuss these issues during consultations? The researchers are investigating this.

At the same time, the researchers are tackling another practical problem: how can we ensure that doctors assess memory, behaviour and daily functioning in a consistent manner? Good tests are available, but they are not yet used everywhere. The researchers at TAP-PAT also aim to change this, so that more people receive a diagnosis in good time and in the correct manner.

See also the project information on TAP-dementia at zonmw.nl.

Basic, applied and psychosocial research

TAP-dementia utilises fundamental, applied, technological and psychosocial research to achieve better and more personalised diagnoses.

All research is carried out in collaboration with the people for whom it is intended. The researchers work together with people with dementia, their loved ones and care professionals at various stages of the research process.

Proteomics for new biomarkers

A key and fundamental part of the research focuses on identifying new biomarkers (substances in the blood or cerebrospinal fluid that indicate dementia and the underlying disease). This is particularly relevant for lesser-known forms such as vascular dementia, Lewy body dementia and frontotemporal dementia.
In one of the projects, TAP-dementia utilises a technique known as proteomics: a method that allows hundreds of proteins in cerebrospinal fluid to be analysed simultaneously in the laboratory. Researchers then investigate which proteins may provide insights into different forms of dementia. Armed with this knowledge, researchers can in turn develop new diagnostic tests.

Improving and validating existing tests

In applied research, TAP-dementia is investigating whether existing diagnostic tests can be used more widely and more effectively. For example, the consortium is examining diagnostic tests that have previously shown promise, such as specific blood and cerebrospinal fluid tests, but which are not yet widely available in clinical practice. TAP-dementia is now investigating these tests in larger and more diverse groups of people to determine whether they are practical for real-world use.

In addition, the researchers are investigating for which people there is added value in having a so-called tau scan (a brain scan that visualises tau proteins and thus detects Alzheimer’s disease). This is necessary because such a scan is expensive and not required for everyone; there are, in fact, cheaper alternatives. They are investigating this by comparing the results of the tau scan with those of alternatives, such as blood tests and computer models; this will enable them to determine for which group of patients the scan is necessary.

AI-supported technology

TAP-dementia is developing computer models capable of analysing large volumes of data, such as brain scan results, memory tests and blood test results. The various models allow researchers to sift through different types of data and answer a range of questions. Through such smart analyses, researchers are trying to identify patterns that will enable doctors to diagnose conditions more accurately. For example, whether someone has vascular dementia or perhaps several conditions at the same time.

Target group research

To ensure that new tests meet the needs of people with dementia, their loved ones and doctors, TAP-dementia also carries out psychosocial research, specifically target group research. Researchers conduct individual and group interviews and distribute questionnaires to understand what people consider important in the diagnostic process. The researchers also investigate the best way to roll out new tests in practice. In doing so, they pay close attention to user-friendliness, clear explanations and digital support.

Improved diagnostic techniques

TAP-dementia is working on, amongst other things, new diagnostic tests, improvements to existing techniques and practical tools.

These are designed to help doctors, researchers and professionals in memory clinics to diagnose the specific condition affecting a person with dementia more quickly and accurately.

A major step towards new tests: biomarkers

TAP-dementia aims to identify new biomarkers that will help determine which condition a person has, particularly for forms of dementia for which no reliable test currently exists, such as frontotemporal dementia or Lewy body dementia. The findings could assist other researchers in developing medicines or targeted treatments.

Smart diagnostic models

TAP-dementia also aims to develop computer models capable of automatically analysing brain scans. Artificial intelligence (AI) can detect patterns of brain damage that we as humans find difficult to recognise. Such a model helps doctors to diagnose the disease(s) in question more quickly and accurately, even when multiple processes are occurring simultaneously.

Better insight into which test is suitable for whom

TAP-dementia provides clear guidelines on which test works best for which person with dementia. Is a blood test sufficient? Or is a PET scan required? TAP-dementia aims to ensure that doctors are given practical guidance to make the right choice for each individual.

Practical tools for clinical practice

TAP-dementia is developing a standard set of tests to assess memory, behaviour and daily functioning. This enables doctors to assess all patients in the same way, wherever they are. The standard set is almost ready for use in all memory clinics.

TAP-dementia is also developing materials and methods to improve communication regarding the diagnosis.

Scientific publications

The results outlined above build on a growing body of scientific evidence that contributes to improved diagnostics and predictions of disease progression in people with memory problems.

The publications below illustrate how TAP-dementia is working to better understand, interpret and make targeted use of diagnostic information in memory clinics. Together, these studies demonstrate how TAP-dementia is working towards a step-by-step improvement in diagnostics: from better understanding what we are measuring, to better predicting what this means for people in clinical practice.

• ‘The impact of tau-PET in a selected memory clinic cohort: rationale and design of the TAP-TAU study’ (link.springer.com). This article shows how researchers are investigating whether a tau-PET scan (which visualises protein build-up in the brain) offers added value for the memory clinic.
• 'Normative population–derived data for MRI manifestations of cerebral small vessel disease' (ahajournals.org). This research helps determine whether changes in the brain are consistent with a normal ageing profile or indicate disease. This enables doctors to better understand MRI results, make more accurate diagnoses and prevent people from becoming unnecessarily anxious.
• ‘Cerebrospinal fluid proteomics in patients with Alzheimer’s disease reveals five molecular subtypes’ (nature.com). It appears that there are five different forms of Alzheimer’s disease, each involving different processes in the brain. This article shows that these differences are visible in the cerebrospinal fluid. It explains why a drug might work for one form of Alzheimer’s but not for another, and highlights the importance of an individualised approach.

For an overview of publications, visit zonmw.nl.

Experiences and information from TAP-dementia

Check LinkedIn, YouTube and the website of the Nederlands Geheugenpoli Netwerk for experiences shared by TAP researchers.

• TAP-dementia.nl
• Posts on LinkedIn.com

Videos about the TAP-TAU and TAP-VaMP sub-projects

Together with the target group

TAP-dementia conducts research for and with the people it concerns: people with dementia, their loved ones and care professionals. This ensures that the findings will be both practical and widely accepted in real-world settings.

Through the TAP-PAT sub-project, TAP-dementia gathers input from so-called users (people who will be putting the results into practice) and end-users (the people for whom it will ultimately make a difference: people with dementia and their loved ones). The consortium organises interviews, focus groups and questionnaires to identify what people consider important in the diagnostic process.

TAP-dementia is also assessing whether new tests and working methods align with the day-to-day practice of memory clinics. The consortium is carrying out this work in collaboration with the Nederlands Geheugenpoli Netwerk.
In this way, TAP-dementia ensures that the research contributes to solutions that memory clinic professionals can actually put into practice; this increases the likelihood of successful implementation.