Improving community health-care systems' early detection of cognitive decline and dementia.

Preliminary estimates suggest that current global health-care systems lack the resource capacity to provide persons with dementia timely access to diagnosis, treatment, and care. There is an increasing need to improve timely identification of individuals who will likely progress to Alzheimer's disease (AD) dementia particularly among under-represented, underserved, and vulnerable populations. The rapidly evolving area of bioinformatics of health system data and the emergence of fluid-based biomarkers for pre-symptomatic AD may provide an innovative strategic option for health system planners. A think-tank style meeting entitled "The Campaign to Prevent Alzheimer's Disease Work Group on Community-Based Detection and Assessment of Cognitive Decline" developed recommendations to guide future sustainability activities, public policy campaigns, and implementation pilots. The group identified and explored different pathways of community-based detection using electronic health records, from different international health-care systems, to detect and surveil individuals with early possible cognitive impairment.