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. 2023 Dec 8;13(12):e077772. doi: 10.1136/bmjopen-2023-077772

Table 1.

Information recorded on TIMC-BRAiN case report form

Item Data recorded
Demographic information
Age Age at assessment (years)
Sex Biological sex (male/female/non-binary)
Level of education Finished formal education (years)
Occupation Occupation (free text)
Age retired Age at retirement (years)
Marital status Non-married/married/divorced/widowed
Driving status Currently driving/ceased driving/never drove
Medical history
Prior stroke/transient ischaemic attack Yes/no
Recurrent syncope Yes/no
Diabetes mellitus5 History of/on diabetes mellitus medication; yes/no
Hypertension History of/on antihypertensive medication; yes/no
Hypercholesterolaemia History of/on antilipidaemic medication; yes/no
Ischaemic heart disease Yes/no
Alcohol excess Yes/no
Epilepsy History of/on antiepileptic medication; yes/no
Concussion/prior head injury Yes/no
History of malignancy Yes/no
Previous anxiety History of/on anxiolytic medication; yes/no
Previous depression History of/on antidepressant medication; yes/no
Hearing impairment Yes/no
Vision impairment Yes/no
Smoking status Yes/no/previous smoker
Family history Memory difficulties/dementia/Alzheimer’s disease/in a first-degree relative; yes/no
Regular medications Medications list; coded using anatomical therapeutic classification system
Anosmia Yes/no
Cognitive symptoms at presentation
Symptom duration Duration of symptoms (in months)
Episodic memory Each item recorded as yes/no indicating recent change at time of assessment
  • Lose track of days

  • Forgetting appointments

  • Misplacing objects

  • Forgetting to pay bills

  • Forgetting how to use appliances

  • Remembering to take medications

Autobiographical memory Recorded as yes/no indicating recent change at time of assessment
  • Forgetting past personal events

Language Each item recorded as yes/no indicating recent change at time of assessment
  • Word-finding difficulties

  • Shrinkage of vocabulary

  • Comprehending Speech

  • Comprehending written information

  • Ability to engage in conversations

Recognition Each item recorded as yes/no indicating recent change at time of assessment
  • Facial recognition

  • Getting lost in familiar areas

  • Changes in using public transport/driving

Informant concerns Each item recorded as yes/no indicating recent change at time of assessment
  • Issues with cooking

  • Issues with orientation

  • Issues with driving

  • Issues with medication compliance

  • Recent falls

Cognitive assessment
RBANS Repeatable Battery for Assessment of Neuropsychological Status
Unadjusted (Raw) score and centile score computed (based on age/education)
Normalisation using Duff norms
  • Index I (immediate memory)

  • Index II (visuospatial/constructional)

  • Index III (language)

  • Index IV (attention)

  • Index V (delayed memory)

  • Global score

ACE-III Addenbrooke’s Cognitive Assessment if unable to complete RBANS
Domain and total scores recorded
  • Attention

  • Memory

  • Fluency

  • Language

  • Visuospatial

  • Overall score

CDR Clinical Dementia Rating Scale
Global score and sum of boxes recorded
  • Memory

  • Orientation

  • Judgement and problem solving

  • Community affairs

  • Home and hobbies

  • Personal care

FAB Frontal Assessment Battery
Total score recorded
AD8 administered to informant Ascertain-Dementia 8 Questionnaire (scored from 8)
CBI-R Cambridge Behavioural Inventory-Revised
Mood and anxiety assessment
HADS-Depression
HADS-Anxiety
Hospital Anxiety and Depression Scales
Total Score Recorded
Probable Depression/Anxiety (Score >10) Recorded
Further clinical assessment
PSQI Pittsburgh Sleep Quality Index (0–21)
TUG Timed-Up-and-Go Test; Time to Complete in seconds recorded
CFS Clinical Frailty Scale to Assess Frailty
MNA Mini Nutritional Assessment Score (0–7: malnourished; 8–11: at risk and 12–14: normal)
Neuroimaging
MRI brain Adjudicated at MDT consensus meeting by a panel of more than two geriatricians/neurologists
  • Fazekas Score 0–3 for white matter disease

  • MTA Score 0–4

  • Koedam Score for Parietal Atrophy Score 0–3

  • Fazekas Score

  • MTA Score

  • Koedam Score

CT brain results CT brain results if performed; free text
FDG-PET results FDG-PET results if performed; free text
DAT results DAT scan results if performed; free text
Blood test results
Haematology results Any abnormalities detected; yes/no; recorded in standard units as per hospital laboratory
  • Full blood count

Biochemistry and other results Any abnormalities detected; yes/no; recorded in standard units as per hospital laboratory
  • Renal profile

  • Liver profile

  • Bone profile

  • Glycated haemoglobin

  • Lipid profile

  • Micronutrients: vitamin B12 and folate

  • Vitamin D

Cerebrospinal fluid results
Diagnostic lumbar puncture results All recorded as pg/mL using Roche Elecsys electrochemiluminesence assay
  • 1–42

  • T-Tau

  • P-Tau

Working (consensus meeting) diagnosis
Working diagnosis at weekly MDT meeting Free text
Final (biobank) diagnosis
Final diagnosis adjudicated following all investigations Functional status
  • Subjective memory complaints

  • Mild cognitive impairment

  • Dementia

Aetiological diagnosis
  • Alzheimer’s disease (amnestic, behavioural, LPA, CBS and PCA variants)

  • Lewy body disease

  • FTD (bvFTD/nfvPPA/svPPA)

  • FTD overlap syndromes: FTD-ALS/FTD-CBS/FTD-PSP

  • CBS: 4R tauopathy

  • PSP

  • Vascular cognitive impairment/dementia

  • Other diagnosis (free text)

  • Genetic diagnosis (free text)

ACE, Addenbrooke’s Cognitive Assessment; ALS, amyotrophic lateral sclerosis; bvFTD, behavioural variant FTD; CBS, corticobasal syndrome; DAT, dopamine transporter scan; FDG, fluorodeoxyglucose; FTD, frontotemporal dementia; LPA, logopenic variant aphasia; MDT, multidisciplinary team; MTA, medial temporal atrophy; nfvPPA, non-fluent agrammatic PPA; PCA, posterior cortical atrophy; PET, positron emission tomography; PPA, primary progressive aphasia; PSP, progressive supranuclear palsy; 4R Tau, 4 repeat tauopathy; svPPA, semantic variant PPA.