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- Frederiksen, Kristian Steen, et al.
(author)
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Focusing on earlier diagnosis of Alzheimer's disease
- 2024
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In: FUTURE NEUROLOGY. - 1479-6708 .- 1748-6971.
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Research review (peer-reviewed)abstract
- Alzheimer's disease (AD) is considered a continuum, progressing from preclinical disease to mild cognitive impairment (MCI) as an early stage, before reaching clinically apparent dementia. Although it is difficult to assess the potential impairments in performance of patients with MCI due to AD, this condition should be diagnosed as early as possible so that, by means of early interventions, patients can maintain their quality of life longer. Healthcare systems should support primary care physicians in their effort to identify patients with MCI due to AD and refer patients to memory clinics and specialists who can provide a reliable diagnosis and initiate appropriate disease management. This review discusses the benefits of earlier AD diagnosis, along with potential challenges and future directions. Healthcare systems need to support primary care physicians to identify patients with MCI due to AD to refer to specialists who can start managing the disease. Read our review on earlier diagnosis of AD.
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| 2. |
- Frederiksen, Kristian Steen, et al.
(author)
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Focusing on Earlier Management of Alzheimer Disease: Expert Opinion Based on a Modified Nominal Group Technique.
- 2024
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In: Alzheimer disease and associated disorders. - 1546-4156. ; 38:1, s. 1-7
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Journal article (peer-reviewed)abstract
- Despite the number of people living with Alzheimer disease (AD), awareness of the early stages of this condition, including mild cognitive impairment due to AD-which poses management challenges-continues to be low. To identify areas for improvement in early AD management, dementia specialists convened in a virtual roundtable meeting.A modified version of the nominal group technique was followed to prioritize specific topics and allow experts to provide their opinions. The overarching topics prioritized and discussed were (1) education and support for primary care physicians on cognitive assessment, detection of mild cognitive impairment, and patient monitoring; (2) nonpharmacological interventions; (3) and the introduction of disease-modifying therapies.Consensus was achieved regarding the need for educating primary care physicians on identifying people with cognitive impairment and for better diagnostic tools for its detection and early management. Management of mild cognitive impairment due to AD should encompass an adequate follow-up schedule aiming to maintain function for as long as possible, and primary care physicians and patients should be aware of the benefits of nonpharmacological interventions.
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| 3. |
- Hampel, Harald, et al.
(author)
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Blood-based biomarkers for Alzheimer's disease: Current state and future use in a transformed global healthcare landscape.
- 2023
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In: Neuron. - 1097-4199. ; 111:18, s. 2781-2799
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Journal article (peer-reviewed)abstract
- Timely detection of the pathophysiological changes and cognitive impairment caused by Alzheimer's disease (AD) is increasingly pressing because of the advent of biomarker-guided targeted therapies that may be most effective when provided early in the disease. Currently, diagnosis and management of early AD are largely guided by clinical symptoms. FDA-approved neuroimaging and cerebrospinal fluid biomarkers can aid detection and diagnosis, but the clinical implementation of these testing modalities is limited because of availability, cost, and perceived invasiveness. Blood-based biomarkers (BBBMs) may enable earlier and faster diagnoses as well as aid in risk assessment, early detection, prognosis, and management. Herein, we review data on BBBMs that are closest to clinical implementation, particularly those based on measures of amyloid-β peptides and phosphorylated tau species. We discuss key parameters and considerations for the development and potential deployment of these BBBMs under different contexts of use and highlight challenges at the methodological, clinical, and regulatory levels.
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| 4. |
- Schindler, Suzanne E., et al.
(author)
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Acceptable performance of blood biomarker tests of amyloid pathology — recommendations from the Global CEO Initiative on Alzheimer’s Disease
- 2024
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In: Nature Reviews Neurology. - 1759-4758. ; 20:7, s. 426-439
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Journal article (peer-reviewed)abstract
- Anti-amyloid treatments for early symptomatic Alzheimer disease have recently become clinically available in some countries, which has greatly increased the need for biomarker confirmation of amyloid pathology. Blood biomarker (BBM) tests for amyloid pathology are more acceptable, accessible and scalable than amyloid PET or cerebrospinal fluid (CSF) tests, but have highly variable levels of performance. The Global CEO Initiative on Alzheimer’s Disease convened a BBM Workgroup to consider the minimum acceptable performance of BBM tests for clinical use. Amyloid PET status was identified as the reference standard. For use as a triaging test before subsequent confirmatory tests such as amyloid PET or CSF tests, the BBM Workgroup recommends that a BBM test has a sensitivity of ≥90% with a specificity of ≥85% in primary care and ≥75–85% in secondary care depending on the availability of follow-up testing. For use as a confirmatory test without follow-up tests, a BBM test should have performance equivalent to that of CSF tests — a sensitivity and specificity of ~90%. Importantly, the predictive values of all biomarker tests vary according to the pre-test probability of amyloid pathology and must be interpreted in the complete clinical context. Use of BBM tests that meet these performance standards could enable more people to receive an accurate and timely Alzheimer disease diagnosis and potentially benefit from new treatments.
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