Alzheimer's disease diagnosis and management: Perspectives from around the world

Abstract

Alzheimer's disease (AD) and other dementias are a global challenge. Early diagnosis is important to manage the disease. However, there are barriers to diagnosis that differ by region. Researchers from Brazil, China, Nigeria, Spain, and Sweden have identified key barriers to AD diagnosis in their countries. In Brazil, socioeconomic inequalities and poor recognition of dementia by physicians can prevent diagnosis. In China, a very large population and lack of physician training in dementia make diagnosis problematic. In Nigeria, socioeconomic inequalities and cultural stigma can stand in the way of diagnosis. In Spain, patient hesitancy and an overloaded health-care system are barriers to diagnosis. In Sweden, inconsistent use of biomarkers is a prominent barrier to diagnosis of AD. To support diagnosis, more focus is needed on education of patients and physicians, increased use of support services, and improved access to biomarkers to accurately diagnose AD.

Keywords: Alzheimer's disease; Brazil; China; Nigeria; Spain; Sweden; biomarkers; socioeconomic inequalities.

FIGURE 1

Patient flow at Ace Alzheimer Center Barcelona. MCI, mild cognitive impairment; PCP, primary care physician; SCD, subjective cognitive decline

FIGURE 2

Core and exploratory biomarkers for Alzheimer's disease. Aβ, beta‐amyloid; CSF, cerebrospinal fluid; NfL, neurofilament light chain; PET, positron emission tomography; pTau, phosphorylated tau; tTau, total tau

FIGURE 3

Barriers and solutions to AD diagnosis. AD, Alzheimer's disease; DMT, disease‐modifying treatment; PCP, primary care physician; MCI, mild cognitive impairment; MD, medical doctor.