Marwan N. Sabbagh, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA,
J Prev Alzheimers Dis. 2020;7(3):158-164. doi: 10.14283/jpad.2020.19.
Disease-modifying pharmacotherapies for Alzheimer's Disease (AD) are currently in late-stage clinical development; once approved, new healthcare infrastructures and services, including primary healthcare, will be necessary to accommodate a huge demand for early and large-scale detection of AD. The increasing global accessibility of digital consumer electronics has opened up new prospects for early diagnosis and management of mild cognitive impairment (MCI) with particular regard to AD. This new wave of innovation has spurred research in both academia and industry, aimed at developing and validating a new "digital generation" of tools for the assessment of the cognitive performance. In light of this paradigm shift, an international working group (the Global Advisory Group on Future MCI Care Pathways) convened to elaborate on how digital tools may be optimally integrated in screening-diagnostic pathways of AD The working group developed consensus perspectives on new algorithms for large-scale screening, detection, and diagnosis of individuals with MCI within primary medical care delivery. In addition, the expert panel addressed operational aspects concerning the implementation of unsupervised at-home testing of cognitive performance. The ultimate intent of the working group's consensus perspectives is to provide guidance to developers of cognitive tests and tools to facilitate the transition toward globally accessible cognitive screening aimed at the early detection, diagnosis, and management of MCI due to AD.
用于治疗阿尔茨海默病(AD)的疾病修饰性药物治疗目前处于临床后期开发阶段;一旦获得批准,将需要新的医疗保健基础设施和服务,包括初级保健,以满足对 AD 进行早期和大规模检测的巨大需求。数字消费电子产品在全球范围内的普及为使用这些电子产品进行轻度认知障碍(MCI)的早期诊断和管理开辟了新的前景,特别是在 AD 方面。这一新的创新浪潮刺激了学术界和工业界的研究,旨在开发和验证新一代用于评估认知表现的工具。鉴于这种范式转变,一个国际工作组(未来 MCI 护理途径全球顾问小组)召开会议,详细讨论了数字工具如何在 AD 的筛查-诊断途径中得到最佳整合。工作组就大规模筛查、在初级医疗保健中检测和诊断 MCI 个体的新算法达成了共识观点。此外,专家组还讨论了与实施认知性能无人监督家庭测试相关的操作方面的问题。工作组共识观点的最终目的是为认知测试和工具的开发人员提供指导,以促进向全球可及的认知筛查过渡,旨在早期发现、诊断和管理由于 AD 引起的 MCI。