Clinical research in dementia: A perspective on implementing innovation

Abstract

The increasing global prevalence of dementia demands concrete actions that are aimed strategically at optimizing processes that drive clinical innovation. The first step in this direction requires outlining hurdles in the transition from research to practice. The different parties needed to support translational processes have communication mismatches; methodological gaps hamper evidence‐based decision‐making; and data are insufficient to provide reliable estimates of long‐term health benefits and costs in decisional models. Pilot projects are tackling some of these gaps, but appropriate methods often still need to be devised or adapted to the dementia field. A consistent implementation perspective along the whole translational continuum, explicitly defined and shared among the relevant stakeholders, should overcome the “research‐versus‐adoption” dichotomy, and tackle the implementation cliff early on. Concrete next steps may consist of providing tools that support the effective participation of heterogeneous stakeholders and agreeing on a definition of clinical significance that facilitates the selection of proper outcome measures.

Translational process

“…Despite increasing involvement of patients in research, frameworks and tools enabling effective interactions of the multiple stakeholders required to bring innovation are scantly available in the academic biomedical field. Interactions between academia and industry are difficult even at pre-competitive levels [1][2][3][4][5][6].…”

Combining reinforcement learning and virtual reality in mild neurocognitive impairment: a new usability assessment on patients and caregivers

“…However, MNI does not negatively interfere with daily activities (Alfano et al, 2022 ; Ferrer-Cairols et al, 2023 ). Subjective cognitive decline (SCD) is defined as a personal health and clinical condition in which an individual's self-perception is affected by worsening cognitive abilities and functioning compared to their previous levels of performance (Boccardi et al, 2022 ; Creavin et al, 2022 ). The literature available emphasizes that people with SCD have a higher risk for suffering dementia than young and older adults without SCD because their subjective cognitive decline partially reflects a fine disease that does not yet meet the MNI criteria or diagnosis (Bellomo et al, 2022 ; Weinstein et al, 2022 ; Bradfield, 2023 ).…”

A framework for addressing Alzheimer's disease: Without a frame, the work has no aim

“…Interventions targeting modifiable risk factors, numerous tools to detect cognitive impairment, development of diagnostic and therapeutic advances, along with effective dementia collaborative care models all represent opportunities to improve the lives of individuals with or at risk for Alzheimer's disease (AD) and related dementias (ADRD). Implementing innovation and translating clinical research in dementia into routine clinical practice will bring numerous additional challenges as others have recently noted 1–3 . As challenging as this is at present, the number of people globally with dementia is projected to increase from 57.4 million in 2019 to 152.8 million in 2050, driven largely by population growth and population aging 4 .…”

“…routine clinical practice will bring numerous additional challenges as others have recently noted. [1][2][3] As challenging as this is at present, the number of people globally with dementia is projected to increase from 57.4 million in 2019 to 152.8 million in 2050, driven largely by population growth and population aging. 4 A "longevity revolution" is being driven not only by more individuals with ADRD, but also increased duration of disability and higher costs of care.…”