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4 September 2017
By using biomarkers specialists can diagnose Alzheimer’s with very high accuracy

Geneva, July 11th 2017 – Diagnosing Alzheimer’s disease is today a much more accurate exercise than it used to be just 5 or 10 years ago. Back then, the dementia specialist making a diagnosis of Alzheimer’s disease was wrong in 1 out of every 3 patients even when memory deficit was consolidated and already disabling. Today, with the use of biomarkers (i.e. disease signatures based on hippocampal atrophy on MRI; cortical hypo-metabolism, amyloid deposition and tau deposition on PET; and abnormal amyloid and tau on lumbar puncture), specialists can diagnose Alzheimer’s with an accuracy approaching 100% up to 5 years earlier than without biomarkers. However, Alzheimer’s biomarkers are not reimbursed by payers and are used in an erratic fashion even in academic memory clinic. The net result to patients is a reduced quality of care and lower chance of receiving the most appropriate therapeutic workup.

European Alzheimer’s biomarkers experts believe that a large part of the responsibility is due to the lack of coordination among research groups working on biomarker development and validation. Fifty of them, including a bunch of young promising scientists, have joined forces and met in Geneva in 2014 to agree on an agenda of research questions that need to be addressed in order to accelerate the transition of biomarkers from research to daily clinical routine.

The questions have been formulated in the context of a framework borrowed from oncology, reminiscent of that in use for drug development for over 50 years. The massive literature search had been published earlier this year in a series of 9 scientific papers in Neurobiology of Aging. The research agenda (aka Geneva roadmap) has been presented in The Lancet Neurology.

We trust that funders of scientific research such as the European Joint Programming for Neurodegenerative Diseases and Innovative Medicine Initiative will uptake the roadmap and use it to inform calls for Alzheimer’s biomarker development and validation. Earlier and more accurate diagnosis is not a sterile diagnostic exercise. It is the cornerstone of treatment with the drugs that will delay the progression of neurodegeneration that are under development and may be on the market in the next few years.

Reference: Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkersLancet Neurology August (2017).

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