Early Stages of Alzheimer's Disease: Evolving the Care Team for Optimal Patient Management

Galvin, James E.; Aisen, Paul S.; Langbaum, Jessica B.; Rodríguez, Eric; Sabbagh, Marwan N.; Stefanacci, Richard G.; Stern, Robert; Vassey, Elizabeth A.; Wilde, Arno de; West, Neva; Rubino, Ivana

doi:10.3389/fneur.2020.592302

Cited by 34 publications

(33 citation statements)

References 30 publications

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“…Usually, a patient with early signs/symptoms of AD will initially present in a primary care setting (30). For some patients, minor changes in cognition and/or behavior may be detected during a routine wellness visit or an appointment to discuss other comorbidities (24). As the PCP is often the first to observe a patient's initial symptomatology, it is vital they recognize the early signs and symptoms, and understand how to use the most appropriate assessment tools designed to detect these early clinical effects of the disease.…”

Section: B -Detectmentioning

confidence: 99%

“…As already raised, recent recommendations for evolving AD care to a more patient-centric, transdisciplinary model include guidance on realizing an efficient diagnostic process-one in which HCPs, payers, and specialists are encouraged to combine their efforts to ensure the early warning signs of AD are not overlooked (24). The recommendations include dividing the diagnosis of AD into the following steps: detect, assess/differentiate, diagnose, and treat (Figure 2).…”

Section: Practical Guide For An Early Diagnosis Of Alzheimer's Diseas...mentioning

confidence: 99%

“…As the prevalence of AD continues to grow, the advancement of AD patient diagnosis will require an orchestrated effort, starting in the primary care setting (24). For patients to receive a timely diagnosis, it is vital to implement an approach that minimizes the burden placed on the patient, clinician, and healthcare system (25).…”

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confidence: 99%

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Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021

et al. 2021

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Alzheimer’s disease is a progressive, irreversible neurodegenerative disease impacting cognition, function, and behavior. Alzheimer’s disease progresses along a continuum from preclinical disease, to mild cognitive and/or behavioral impairment and then Alzheimer’s disease dementia. Recently, clinicians have been encouraged to diagnose Alzheimer’s earlier, before patients have progressed to Alzheimer’s disease dementia. The early and accurate detection of Alzheimer’s disease-associated symptoms and underlying disease pathology by clinicians is fundamental for the screening, diagnosis, and subsequent management of Alzheimer’s disease patients. It also enables patients and their caregivers to plan for the future and make appropriate lifestyle changes that could help maintain their quality of life for longer. Unfortunately, detecting early-stage Alzheimer’s disease in clinical practice can be challenging and is hindered by several barriers including constraints on clinicians’ time, difficulty accurately diagnosing Alzheimer’s pathology, and that patients and healthcare providers often dismiss symptoms as part of the normal aging process. As the prevalence of this disease continues to grow, the current model for Alzheimer’s disease diagnosis and patient management will need to evolve to integrate care across clinical disciplines and the disease continuum, beginning with primary care. This review summarizes the importance of establishing an early diagnosis of Alzheimer’s disease, related practical ‘how-to’ guidance and considerations, and tools that can be used by healthcare providers throughout the diagnostic journey.

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Section: B -Detectmentioning

confidence: 99%

Section: Practical Guide For An Early Diagnosis Of Alzheimer's Diseas...mentioning

confidence: 99%

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Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021

et al. 2021

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“…Currently, Alzheimer's disease (AD) has become the most common cause of dementia for global population, which has significantly impaired the activities of daily living as well as the quality of life in these patients (1,2). Despite of continuous efforts in the development of novel treatments, therapeutic strategies for patients with AD, as well as those with dementia of other causes, remain limited, and the prognosis of patients with AD are still poor (3)(4)(5).…”

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confidence: 99%

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Zhao

et al. 2021

Front. Med.

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Background: Previous studies evaluating the relationships of glaucoma with Alzheimer's disease (AD) and dementia showed inconsistent results. We performed a meta-analysis of cohort studies to evaluate the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia.Methods: Cohort studies which evaluated the association between glaucoma with incidence of AD, all-cause dementia, and non-AD dementia in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Cochrane's Library databases. A random-effects model incorporating the potential intra-study heterogeneity was used for the meta-analysis.Results: Eleven cohort studies including 4,645,925 participants were included. Results showed that compared to those without glaucoma at baseline, adult patients with glaucoma was not independently associated with increased incidence of AD [adjusted risk ratio (RR): 1.03, 95% confidence interval (CI): 0.93–1.05, P = 0.55; I2 = 83%], all-cause dementia (adjusted RR: 1.08, 95% CI: 0.97–1.19, P = 0.15; I2 = 79%), or non-AD dementia (adjusted RR: 1.05 95% CI: 0.91–1.21, P = 0.49; I2 = 82%). Sensitivity analyses by excluding one study at a time did not significantly affect the results of the meta-analyses. Moreover, subgroup analyses showed consistent results in meta-analysis of prospective or retrospective cohort studies, and in meta-analysis of patients with primary open-angle glaucoma or primary angle-closure glaucoma (P-values for subgroup difference all > 0.05).Conclusions: Current evidence from cohort studies did not support that glaucoma is an independent risk factor of AD, all-cause dementia, or non-AD dementia in adult population.

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“…In addition, a more impactful participation of policymakers and service providers is of vital importance in this transformation phase (Steiner et al, 2020 ). The infrastructures’ modernization would also strongly contribute to a more effective patient-centered management satisfying personalized requirements (Galvin et al, 2021 ).…”

Section: Towards Better Clinical Trials Design and Developmentmentioning

confidence: 99%

Intercepting Dementia: Awareness and Innovation as Key Tools

Brai

Tonacci

Brugada-Ramentol³

et al. 2021

Front. Aging Neurosci.

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Dementia is a common feature of several age-related brain diseases, leading to a progressive cognitive decline. Due to a growing aging rate, dementia-related disorders currently affect around 50 million people worldwide and by 2050 this number is expected to reach 150 million. Additionally to patients, these neurodegenerative pathologies have a strong impact on family members, caretakers, and other health professionals, therefore representing a public health burden that in 2020 accounted for over 1 trillion USD and is projected to nearly double in the next decade. To overcome this devastating condition, many organizations and collaborative networks sustain that only a complete understanding of dementia in its different characteristics can drive the scientific community towards the development of effective therapeutic approaches aiming at preventing its onset and halting its progression.In this work, we discuss two topics that represent fundamental resources in fighting dementia: (i) the importance of raising awareness about this condition to avoid stigma and gauging investment; and (ii) the introduction of novel screening measures to prevent and potentially revert cognitive decline. Finally, we discern how knowledge-based advocacy will help the rollout of clinical trials and the development of novel and timely pharmacological interventions.

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Early Stages of Alzheimer's Disease: Evolving the Care Team for Optimal Patient Management

Cited by 34 publications

References 30 publications

Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021

Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021

Glaucoma Is Not Associated With Alzheimer's Disease or Dementia: A Meta-Analysis of Cohort Studies

Intercepting Dementia: Awareness and Innovation as Key Tools

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