Rethinking the detection and diagnosis of Alzheimer's disease: Outcomes of a European Brain Council project

Abstract

Alzheimer's disease (AD), the most common form of dementia, is a progressive and debilitating neurodegenerative condition which robs people of their memory, their independence, their relationships and, ultimately, their lives. It affects close to 7 million people in the European Union (EU) alone. The detection and diagnosis of AD relies on a system that remains focused on the late stage of the disease, despite a better understanding of the disease progression. Clinical practice and healthcare systems' readiness to detect, diagnose and treat the disease effectively are still lagging. The use of biomarkers (cerebrospinal fluid tests (CSF) and positron emission tomography scans (PET)), which are central to a diagnostic assessment for people with AD symptoms, as well as relevant diagnostic facilities are under-utilised. PET imaging is expensive and of limited availability, and CSF sampling may be considered invasive. The European Brain Council's 'Rethinking Alzheimer's disease: Detection and diagnosis' White Paper has looked at the barriers to early diagnosis and how the healthcare systems infrastructure for detection and diagnosis of AD need to be transformed in order for people with AD to benefit from innovative solutions once they become approved for use.

Keywords: Alzheimer’s disease; Biomarkers; Detection; Diagnosis; Preparedness.

Fig. 1

Alzheimer’s Disease Continuum (Alzheimer’s disease facts and figures. Alzheimer’s Dementia, 2020) .

Fig. 2

Current and new detection and diagnosis pathways.

Fig. 3

Population attributable fraction of potentially modifiable risk factors for dementia Adjusting the healthcare workforce and services.