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. 2025 Mar 11;17(1):e70095.
doi: 10.1002/dad2.70095. eCollection 2025 Jan-Mar.

Opportunities to encourage adoption of a biomarker-enabled care pathway for Alzheimer's in primary care

Soo Borson  1 , Rhoda Au  2 , Anna H Chodos  3 , Sam Gandy  4 , Holly Jain  5 , Amy Alagor  5 , Kristi Cohn  5 , Diana R Kerwin  6 , Jacobo Mintzer  7 , Stephanie Monroe  8 , Delecia Robinson  9 , Michelle M Mielke  10 , Donna M Wilcock  11
Affiliations

Opportunities to encourage adoption of a biomarker-enabled care pathway for Alzheimer's in primary care

Soo Borson et al. Alzheimers Dement (Amst). .

Abstract

Identification of early-stage Alzheimer's disease (AD) remains a challenge due to limited specialist availability, diagnostic access, disease awareness, and cultural factors. Blood-based biomarkers (BBBM) could play a critical role in the identification and referral of patients suspected of AD to specialty care. A multidisciplinary AD Biomarker Task Force was convened to evaluate current biomarker use cases, define an optimal biomarker-enabled AD diagnostic care pathway, and understand factors impacting adoption. The Task Force identified opportunities to support biomarker-enabled AD diagnostic care pathway adoption, including streamlining risk assessment and screening by leveraging digital tools, activating primary care providers through education, generating data to expand applicability to diverse populations, and advocating for aligned policies and quality measures. Adoption of BBBMs in the primary care setting will be critical to improve early AD detection. However, challenges to pathway adoption persist and will require action from clinicians, payers, policy makers, and patients to address.

Highlights: Blood-based biomarkers can streamline the identification of AD in primary care.Future biomarker-enabled diagnostic care pathways will leverage digital assessments.Education, data generation, and policy advocacy are vital to encourage BBBM use.Implementation of AD care pathways requires the activation of diverse stakeholders.

Keywords: Alzheimer's disease; artificial intelligence (AI); blood‐based biomarkers; care pathway; digital tools; primary care; quality measure.

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Conflict of interest statement

S.B. has served as a consultant to Novo Nordisk, Roche Genentech, Biogen, Eisai, Abbvie, Lilly, and Linus Health. S.B. has received compensation from Medscape and WebMD for non‐CME/CE services. R.A. has served as a scientific advisor to Signant Health and Novo Nordisk. A.C. has received funding from the National Institute of Neurological Disorders and Stroke, California Department of Health Care Services, California Department of Public Health, Gary and Mary West Health Institute, and Health Resources and Services Administration. A.C. has received honoraria from Emory University, Peerview, Medscape Education, and Advanced Health Media Push. Archstone Foundation has provided A.C. support for attending meetings. S.G. is a co‐founder of Recuerdo Pharmaceuticals. S.G. has served as a consultant in the past for J&J, Diagenic, and Pfizer, and currently consults for Cognito Therapeutics, GLG Group, SVB Securities, Guidepoint, Third Bridge, MEDACORP, Altpep, Vigil Neurosciences, and Eisai. S.G. has received research support in the past from Warner‐Lambert, Pfizer, Baxter, and Avid. S.G. currently receives research support from NIH grants U01AG046170, RF1AG058469, RF1AG059319, R01AG061894, P30 AG066514 to Mary Sano, and from the Cure Alzheimer's Fund. D.K. has been a paid consultant or served on the advisory board for Eli Lilly, Eisai, Roche/Genentech, Acumen, Wellin5/Therachat, and Med Learning Group. J.M. has served as a consultant for Genentech, Inc., AARP—Global Council on Brain Health (GCBH), ACADIA, Alliance for Aging Research, AiOmed, Axsome, Exciva, Lundbeck, Merry Life, Praxis Bioresearch, and Otsuka/Avanir. J.M. has received research support from National Institute on Aging, National Institutes for Health, Alzheimer's Association, Eisai Inc., GHR Foundation, Eli Lilly and Company, Cerevel Therapeutics, LLC, and GSK Research & Development Limited, National Endowment for the Arts. Additionally, J.M. has also received research support from American Association of Retired Persons (AARP), Karuna Tx, Alzheimer's Drug Discovery Foundation, Cognition Therapeutics, Inc., Suven Life Sciences Ltd., and Vivoryon Therapeutics. J.M. has received payments from ACADIA, Genentech, Inc., and Alliance for Aging Research for presentations. ACADIA, AARP—Global Council on Brain Health (GCBH), AiOmed, Alzheimer's Clinical Trials Consortium (ACTC), Alzheimer's Therapeutic Research Institute (ATRI), Axsome, Genentech, Inc., Lundbeck, and Merry Life have provided J.M. support to attend meetings. J.M. has served on the advisory board or data safety monitoring board for AARP—Global Council on Brain Health (GCBH), ACADIA, Alzheimer's Therapeutic Research Institute (ATRI), Alzheimer's Clinical Trials Consortium (ACTC), Alzheimer's Association, and Alliance for Aging Research. J.M. has also served on the served on the advisory board or data safety monitoring board for Axsome, Exciva, International Psychogeriatric Association (IPA), NAB‐IT: Nabilone for Agitation Blinded Intervention Trial, CALM‐IT: Cannabinoid Liquid Medication Intervention Trial, Technology Accelerator Company (TAC), and Praxis Bioresearch. J.M holds stocks from Biopharma Connex, NeuroQuest, and Recruitment Partners. S.M. served as a consultant to the University of Southern California, Alzheimer's Therapeutic Research Institute/Alzheimer's Clinical Trials Consortium (ACTC). M.M. received research funding from the NIH, DOD, Alzheimer's Association, and Davos Alzheimer's Collaborative. M.M. has consulted for or served on the advisory boards for Althira, Novo Nordisk, Biogen, Danahar, Eisai, Lilly, Roche, Siemens Healthineers, and Sunbird Bio. D.W. served as a paid consultant or advisory board member for SynapsDx and Novo Nordisk. Additionally, D.W. serves as the editor‐in‐chief of Alzheimer's & Dementia. All other authors report no conflicts of interest. Author disclosures are available in the supporting information.

Figures

FIGURE 1
FIGURE 1
Proposed future biomarker‐enabled AD diagnostic care pathway for primary care clinical care settings. Description: A proposed AD diagnostic care pathway leveraging blood‐based biomarkers to improve early AD detection in primary care settings. AD, Alzheimer's disease.
See this image and copyright information in PMC

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