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                <text>The critical role of primary care clinicians (PCCs) in Alzheimer's disease (AD) prevention, diagnosis and management must evolve as new treatment paradigms and  disease-modifying therapies (DMTs) emerge. Our understanding of AD has grown  substantially: No longer conceptualized as a late-in-life syndrome of cognitive and  functional impairments, we now recognize that AD pathology builds silently for  decades before cognitive impairment is detectable. Clinically, AD first manifests  subtly as mild cognitive impairment (MCI) due to AD before progressing to dementia.  Emerging optimism for improved outcomes in AD stem from a focus on preventive  interventions in mid-life and timely, biomarker-confirmed diagnosis at early signs  of cognitive deficits (ie, MCI due to AD and mild AD dementia). A timely AD  diagnosis is particularly important for optimizing patient care and enabling the  appropriate use of anticipated DMTs. An accelerating challenge for PCCs and AD  specialists will be to respond to innovations in diagnostics and therapy for AD in a  system that is not currently well positioned to do so. To overcome these challenges,  PCCs and AD specialists must collaborate closely to navigate and optimize  dynamically evolving AD care in the face of new opportunities. In the spirit of this  collaboration, we summarize here some prominent and influential models that inform  our current understanding of AD. We also advocate for timely and accurate (ie,  biomarker-defined) diagnosis of early AD. In doing so, we consider evolving issues  related to prevention, detecting emerging cognitive impairment, and the role of  biomarkers in the clinic.</text>
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