Considerations regarding a diagnosis of Alzheimer’s Disease before dementia: a systematic review

Abstract

Introduction: The NIA-AA research framework proposes a purely biological definition of Alzheimer's Disease (AD). This implies AD can be diagnosed based on biomarker abnormalities. While this brings opportunities, it also raises challenges. Methods: We conducted a systematic review by searching PubMed for publications on conveying AD biomarker results to individuals without dementia. Content was analyzed inductively. Results: We included 25 publications. From these we extracted 26 considerations, which we grouped according to their primary relevance to a clinical, personal, or societal context. Clinical considerations include (lack of) validity, utility, and disclosure protocols. Personal considerations cover psychological and behavioral implications, as well as the right to (not) know. Societal considerations comprise the risk of misconception, stigmatization, and discrimination. Overall, views were heterogeneous and often contradictory. Discussion: Perceptions on a diagnosis of AD before dementia vary widely. Empirical research is required, taking perspectives of medical professionals and the general public into account.

Impact of sharing Alzheimer's disease biomarkers with individuals without dementia: A systematic review and meta‐analysis of empirical data

“…24,25 To address these issues, we recently conducted a systematic review of theoretical data, and identified 26 diverse and contradictory considerations related to a clinical, personal, and societal context. 26 A next step is to examine how these, and perhaps other, aspects are perceived by stakeholders, including the general public, patients, families, and health-care professionals. In this study, we therefore aimed to provide an overview of empirical data on expected and experienced implications of sharing AD biomarker results with individuals who do not have dementia (yet).…”

Identifying interactions in omics data for clinical biomarker discovery using symbolic regression

“…Despite many decades of research, neurodegenerative diseases remain a major threat to human health and are a substantial cause of mortality. Alzheimer's disease (AD) is the most common type of dementia, and currently no therapeutics can halt or significantly slow its fatal progression [33]. Furthermore, short of an autopsy, there is no definitive way to diagnose AD and it is in general impossible to predict who will develop the disease.…”