Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden.
Alzheimers Dement. 2024 Nov;20(11):8172-8182. doi: 10.1002/alz.14219. Epub 2024 Sep 23.
Early diagnosis is crucial to treatment success. This is especially relevant for Alzheimer's disease (AD), with its protracted preclinical phase. Most health care systems do not have the resources to conduct large-scale AD screenings in middle-aged individuals in need of novel AD treatment options and early, accurate diagnosis. Recent developments in blood-based biomarkers and remote cognitive testing offer novel, cost-effective, and scalable methods to detect cognitive and biomarker changes that may indicate early AD. In research cohorts, promising results have been reported, but these modalities have not been validated in population-based settings. The validation of a realistic screening approach for early Alzheimer's disease (REAL AD) study aims to validate the diagnostic and prognostic performance of the combined use of blood-based biomarkers and remote cognitive testing as a screening approach for early AD employing an existing health care infrastructure (the Swedish Västra Götaland Region Primary Healthcare). REAL AD aims to provide a concrete, individualized diagnostic framework, which could significantly improve AD prognosis. HIGHLIGHTS: In Sweden, most Alzheimer's disease (AD) diagnoses are made in primary care, where access to AD biomarkers is almost non-existent. Most health care systems have limited resources for the screening of middle-aged adults for early evidence of AD pathology. Blood-based biomarkers and remote cognitive testing offer novel, cost-effective, and scalable methods for detecting cognitive and biomarker changes that may indicate early AD. The REAL AD study aims to validate the diagnostic and prognostic performance of blood-based biomarkers and remote cognitive testing as a screening approach for early AD in an existing primary health care infrastructure in the Västra Götaland Region in Sweden. Studies such as REAL AD will play a vital role in helping to move the field toward concrete implementation of biomarkers in AD diagnostic workup at all care levels, eventually providing more comprehensive treatments options for the large and growing AD population, and for those at risk.
早期诊断对于治疗的成功至关重要。这对于阿尔茨海默病（AD）尤其相关，因为它有一个漫长的临床前期。大多数医疗保健系统没有资源对需要新的 AD 治疗方案和早期、准确诊断的中年个体进行大规模 AD 筛查。基于血液的生物标志物和远程认知测试的最新发展提供了新颖、具有成本效益且可扩展的方法来检测可能表明早期 AD 的认知和生物标志物变化。在研究队列中，已经报道了有前途的结果，但这些方法尚未在基于人群的环境中得到验证。REAL AD 研究旨在验证基于血液的生物标志物和远程认知测试的联合使用作为一种利用现有医疗保健基础设施（瑞典西约塔兰省初级保健）进行早期 AD 筛查的方法的诊断和预后性能，该研究的目的是验证基于血液的生物标志物和远程认知测试的联合使用作为一种利用现有医疗保健基础设施（瑞典西约塔兰省初级保健）进行早期 AD 筛查的方法的诊断和预后性能。REAL AD 旨在提供一个具体的、个体化的诊断框架，这可以显著改善 AD 的预后。要点：在瑞典，大多数 AD 诊断是在初级保健中做出的，而 AD 生物标志物的获取几乎不存在。大多数医疗保健系统资源有限，无法对中年成年人进行早期 AD 病理筛查。基于血液的生物标志物和远程认知测试为检测可能表明早期 AD 的认知和生物标志物变化提供了新颖、具有成本效益且可扩展的方法。REAL AD 研究旨在验证基于血液的生物标志物和远程认知测试作为一种在瑞典西约塔兰省现有初级卫生保健基础设施中筛查早期 AD 的方法的诊断和预后性能。REAL AD 等研究将在帮助推动该领域在所有护理水平上将生物标志物具体应用于 AD 诊断工作中发挥重要作用，最终为庞大且不断增长的 AD 人群以及有患病风险的人群提供更全面的治疗选择。
