Timely Diagnosis for Alzheimer’s Disease: A Literature Review on Benefits and Challenges

Abstract

Background:Timely diagnosis of Alzheimer’s disease (AD) refers to a diagnosis at the stage when patients come to the attention of clinicians because of concerns about changes in cognition, behavior, or functioning and can be still free of dementia and functionally independent.Objectives:To comprehensively review existing scientific evidence on the benefits and potential challenges of making a timely diagnosis of AD.Methods:Relevant studies were identified by searching electronic databases (Medline, Embase) and bibliographies for studies published in English between 1 January 2000 and 2 June 2014 on the consequences of a timely diagnosis of AD.Results:Nine studies were identified that investigated the consequences of diagnosing AD at the initial stages; none were specifically focused on prodromal AD. A timely diagnosis potentially offers the opportunities of early intervention, implementation of coordinated care plans, better management of symptoms, patient safety, cost savings, and postponement of institutionalization. Barriers to making a timely diagnosis include stigma, suicide risk, lack of training, diagnostic uncertainty, shortage of specialized diagnostic services, and the reluctance of healthcare providers to make a diagnosis when no effective disease-modifying options are available.Conclusions:Despite its potential benefits, few published studies have explored the advantages or risks of a timely diagnosis of AD. In light of the cultural shift toward diagnosis at the initial stage of the disease continuum, when the patient does not yet have dementia, more investigations are needed to evaluate the benefits and address the barriers that may impede making a timely AD diagnosis.

Perceptions of stigma among people affected by early- and late-onset Alzheimer’s disease

“…Increasing incidence has resulted in a heightened drive towards early diagnosis (Aminzadeh et al, 2012), to allow people as much time as possible to plan their future (Dubois et al, 2016). Importantly, diagnosis of Alzheimer's disease exposes people to negative attitudes and beliefs (Garand et al, 2009), known as stigma (Goffman, 1963).…”

[P1–592]: Cost of Diagnosing Dementia in a German Memory Clinic

“…Thus, the cost of diagnosing dementia disease represents only a small proportion of 1% at the current rate of referral. However, a timely diagnosis allows prompt initiation of pharmacological and nonpharmacological interventions and prevents inappropriate treatment of patients with false-positive diagnoses [42,43]. These opportunities could lead to a reduction in healthcare costs, especially due to a delayed need for care and institutionalization [44][45][46].…”

A Surgical Method to Improve the Homeostasis of CSF for the Treatment of Alzheimer’s Disease

“…This chronic degenerative disease of the brain is characterized clinically by progressive deterioration of memory and other cognitive domains, along with profound changes in personality and behavior (Dubois et al, 2015). Amyloid-β (Aβ) and protein tau have long been recognized as the major pathogenic factors (Kandimalla et al, 2013), and are highlighted in the major consensus criteria for the diagnosis of AD at autopsy (Mirra et al, 1991).…”