Opportunities to encourage adoption of a biomarker-enabled care pathway for Alzheimer's in primary care.

IF 4.4 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2025-03-11 eCollection Date: 2025-01-01 DOI:10.1002/dad2.70095
Soo Borson, Rhoda Au, Anna H Chodos, Sam Gandy, Holly Jain, Amy Alagor, Kristi Cohn, Diana R Kerwin, Jacobo Mintzer, Stephanie Monroe, Delecia Robinson, Michelle M Mielke, Donna M Wilcock
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Abstract

Identification of early-stage Alzheimer's disease (AD) remains a challenge due to limited specialist availability, diagnostic access, disease awareness, and cultural factors. Blood-based biomarkers (BBBM) could play a critical role in the identification and referral of patients suspected of AD to specialty care. A multidisciplinary AD Biomarker Task Force was convened to evaluate current biomarker use cases, define an optimal biomarker-enabled AD diagnostic care pathway, and understand factors impacting adoption. The Task Force identified opportunities to support biomarker-enabled AD diagnostic care pathway adoption, including streamlining risk assessment and screening by leveraging digital tools, activating primary care providers through education, generating data to expand applicability to diverse populations, and advocating for aligned policies and quality measures. Adoption of BBBMs in the primary care setting will be critical to improve early AD detection. However, challenges to pathway adoption persist and will require action from clinicians, payers, policy makers, and patients to address.

Highlights: Blood-based biomarkers can streamline the identification of AD in primary care.Future biomarker-enabled diagnostic care pathways will leverage digital assessments.Education, data generation, and policy advocacy are vital to encourage BBBM use.Implementation of AD care pathways requires the activation of diverse stakeholders.

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鼓励在初级保健中采用生物标志物支持的阿尔茨海默病护理途径的机会。
早期阿尔茨海默病(AD)的识别仍然是一个挑战,由于有限的专家可用性、诊断途径、疾病意识和文化因素。基于血液的生物标志物(BBBM)可能在阿尔茨海默病疑似患者的识别和转诊到专科治疗中发挥关键作用。召集了一个多学科的AD生物标志物工作组,以评估当前的生物标志物使用案例,定义最佳的生物标志物支持AD诊断护理途径,并了解影响采用的因素。工作组确定了支持采用生物标志物支持的AD诊断护理途径的机会,包括利用数字工具简化风险评估和筛查,通过教育激活初级保健提供者,生成数据以扩大对不同人群的适用性,以及倡导一致的政策和质量措施。在初级保健机构中采用血脑屏障对提高早期阿尔茨海默病的发现至关重要。然而,路径采用的挑战仍然存在,需要临床医生、支付方、政策制定者和患者采取行动来解决。重点:基于血液的生物标志物可以简化初级保健中AD的识别。未来基于生物标志物的诊断护理途径将利用数字评估。教育、数据生成和政策宣传对于鼓励BBBM的使用至关重要。实施阿尔茨海默病护理途径需要激活不同的利益相关者。
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来源期刊
CiteScore
7.80
自引率
7.50%
发文量
101
审稿时长
8 weeks
期刊介绍: Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.
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