MD Magazine (August 19, 2019): Alzheimer Disease: Appropriate Diagnosis and Management

Jeffrey L. Cummings, MD, ScD: Why is early diagnosis such a challenge to clinicians, and what’s the importance of timely diagnosis and early recognition? Dr Atri, could I ask you to address this question?

Alireza Atri, MD, PhD: Sure. Thanks, Jeff. I think it has to do with…a misperception about the value that diagnosis and treatment can provide. There’s an issue of proficiency for clinicians. There are issues with knowledge, time, and resources. I think that all those things are actually surmountable with better education and appreciation.… When you look at Alzheimer disease and related dementias in a spectrum and when you add family education; care of the caregiver; detection early when individuals are at their highest peak to be able to make their own decisions and are able to have autonomy and be empowered to make decisions about their own lives, get on medications, change lifestyles, and have a supportive environment, these are actually meaningful. This is something that cannot be addressed by 1 demographic or 1 stakeholder. It requires health care systems to be involved, as well as clinicians, educators, and family members.

Over time…we’ll have a bit more clarity regarding…the pathways for best practices. I’ll put in a plug, because we’ve been working on this in a multidisciplinary work group for the Alzheimer’s Association for clinical best practices. Nineteen recommendations will come out later this year regarding the whole process of evaluation in a primary care setting…, specialty setting, or subspecialty setting, including how to take concerns, how to do the evaluation, what testing to do, what are the recommendations regarding imaging and other biomarkers, and how to actually disclose the diagnosis. I’m actually really hopeful that we can reach primary care clinicians and help them implement these recommendations. But it’s going to require multiple stakeholders to make this happen.

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