Original Public acceptability of lumbar puncture in the diagnosis of Alzheimer's disease: a questionnaire-based single center study in China

Aim: To investigate public acceptability of lumbar puncture in the diagnosis of Alzheimer's disease and to find out the factors influencing patient decision. Methods: We administered a questionnaire to participants who were native to Xi'an using the "Sojump" application. Participants were required to answer the questionnaire on their cell phones following the instructions. The questions of the questionnaire were divided into four categories, including demographic data, awareness of lumbar puncture, attitudes toward lumbar puncture for the diagnosis of Alzheimer's disease, and reasons for negative attitude. Logistic regression was used to analyze the factors influencing the attitude toward lumbar puncture testing. Results: A total of 1050 valid questionnaires were collected, including 403 (38.4%) from non-medical personnel and 647 (61.6%) from medical personnel. Among them, 35.7% of the participants knew about lumbar puncture examinations. Regarding the attitude, 862 participants (82.1%) had a positive attitude toward lumbar puncture in the diagnosis of Alzheimer's disease, and 508 (58.9%) of them considered lumbar puncture to be helpful in confirming the diagnosis. Multivariate analysis revealed that factors associated with a positive attitude in the non-medical group included age (OR=0.963, P=0.003, 95% CI: 0.939-0.987), education level (OR=2.073, P=0.037, 95% CI: 1.044-4.114), monthly income (OR=1.340, P=0.031, 95% CI: 1.028-1.748), and type of occupation (OR=1.569, P=0.038, 95% CI: 1.026-2.400). Factors associated with a positive attitude in the medical group included place of residence (OR=9.182, P=0.036, 95% CI: 1.151-73.238), monthly income (OR=4.008, P=0.002, 95% CI: 1.689-9.511), and hospital level (OR=38.311, P < 0.001, 95% CI: 14.323-102.478). Conclusions: More than 80% of the public has a positive attitude towards lumbar puncture in the diagnosis of Alzheimer's disease, suggesting high acceptability. However, the attitude toward lumbar puncture is depend on age, education level, economic status, and type of occupation.