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. 2021 Jan 22:11:592302.
doi: 10.3389/fneur.2020.592302. eCollection 2020.

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

James E Galvin  1 , Paul Aisen  2 , Jessica B Langbaum  3 , Eric Rodriguez  4 , Marwan Sabbagh  5 , Richard Stefanacci  6 , Robert A Stern  7 , Elizabeth A Vassey  7 , Arno de Wilde  8 , Neva West  9 , Ivana Rubino  9
Affiliations

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

James E Galvin et al. Front Neurol. .

Abstract

Alzheimer's disease (AD) is a progressive, neurodegenerative disease that creates complex challenges and a significant burden for patients and caregivers. Although underlying pathological changes due to AD may be detected in research studies decades prior to symptom onset, many patients in the early stages of AD remain undiagnosed in clinical practice. Increasing evidence points to the importance of an early and accurate AD diagnosis to optimize outcomes for patients and their families, yet many barriers remain along the diagnostic journey. Through a series of international working group meetings, a diverse group of experts contributed their perspectives to create a blueprint for a patient-centered diagnostic journey for individuals in the early stages of AD and an evolving, transdisciplinary care team. Here, we discuss key learnings, implications, and recommendations.

Keywords: Alzheimer's disease; dementia; diagnosis; early detection; mild cognitive impairment.

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Conflict of interest statement

JG has been a paid consultant for Biogen. PA reports grants from, NIA, FNIH, the Alzheimer's Association, Janssen, Lilly, and Eisai, and personal fees from Merck, Roche, Biogen, Lundbeck, ImmunoBrain Checkpoint, and Samus. JL reports grants from the National Institutes of Health (NIH/NIA), Alzheimer's Association, FBRI, Novartis, and Roche. ER received assistance from Biogen with conference expenses including honorarium and travel/lodging expenses in May 2017. MS has intellectual property rights (royalties or patent sales with Harper Collins. He has ownership interest (stock, stock options) with Versanum Inc, Brain Health Inc, Optimal Cognitive Health Company, uMethod Health, and NeuroReserve. He has been a consultant for Biogen, Signant Bracket, Eisai, Alzheon, Athira, NeuroReserve, Stage 2 innovation, vTv therapeutics, Regeneron, Neurotrope, and Roche-Genentech. RS is a speaker for Biogen and a Medical Director for EVERSANA, which does work for Biogen. RAS received consulting fees as a member of the ADvance International Working Group, which was unrelated to the current manuscript. He has stock options as a member of the Board of Directors of King Devick Technologies. He has received royalties from Psychological Assessment Resources, Inc for published neuropsychological tests. He has received consulting fees from NCAA Concussion Settlement as a member of the Medical Scientific Committee. EV has received grant support from Eli Lilly, Biogen, Hoffman-LaRoche, Cognito Therapeutics, Eisai, National Institutes of Health (NIH/NIA), Cortexyme, and Avanir. She is a consultant for Biogen and Cognito Therapeutics. NW was an employee of Biogen at the time of this work. IR is an employee of Biogen. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Proposed blueprint for pathways of entry into an integrated AD care team and potential roles of HCPs within the AD care team. AD, Alzheimer's disease; cog, cognitive; HCP, healthcare professional; MRI, magnetic resonance imaging; NP, nurse practitioner; PCP, primary care physician.
See this image and copyright information in PMC

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