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Text
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<a href="http://doi.org/10.1111/joim.13244" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/joim.13244</a>
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ISSN
1365-2796 0954-6820
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Update Year & Number
February 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Family & Community Medicine
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Title
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Practical Recommendations for Timely, Accurate Diagnosis of Symptomatic Alzheimer's Disease (MCI and Dementia) in Primary Care: A Review and Synthesis.
Date
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2021
2021-01-18
Subject
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Alzheimer Disease; Biomarkers; Dementia; Disease-Modifying Therapies; Mild Cognitive Impairment; Primary Health Care
Creator
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Liss JL;Seleri MAS;Cummings J;Atri A;Geldmacher DS;Candela SF;Devanand DP;Fillit HM;Susman J;Mintzer J;Bittner T;Brunton SA;Kerwin DR;Clay JW;Small GW;Grossberg GT;Clevenger CK;Cotter V;Stefanacci R;Wise-Brown A;Sabbagh MN
Description
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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.
Identifier
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<a href="http://doi.org/10.1111/joim.13244" target="_blank" rel="noreferrer noopener">10.1111/joim.13244</a>
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journalArticle
Publisher
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Journal Of Internal Medicine
2021
Alzheimer disease
Atri A
Biomarkers
Bittner T
Brunton SA
Candela SF
Clay JW
Clevenger CK
Cotter V
Cummings J
dementia
Department of Family & Community Medicine
Devanand DP
Disease-Modifying Therapies
February 2021 List
Fillit HM
Geldmacher DS
Grossberg GT
Journal Of Internal Medicine
journalArticle
Kerwin DR
Liss JL
Mild Cognitive Impairment
Mintzer J
NEOMED College of Medicine
Primary Health Care
Sabbagh MN
Seleri MAS
Small GW
Stefanacci R
Susman J
Wise-Brown A