Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Nat Rev Neurol. 2024 Dec;20(12):738-746. doi: 10.1038/s41582-024-01033-y. Epub 2024 Oct 25.
Several major challenges, including an ageing population and declining workforce and the implementation of recent breakthrough therapies for Alzheimer disease, are prompting a necessary rethink of how people with neurodegenerative dementias are diagnosed and medically managed. Digital health technologies could play a pivotal part in this transformation, with new advances enabling the collection of millions of data points from a single individual. Possible applications include unobtrusive monitoring that aids early detection of disease and artificial intelligence-based health advice. To translate these advances to meaningful benefits for people living with a disease, technologies must be implemented within a system that retains the physician expert as a central figure in decision-making. This Perspective presents a new framework, termed the Digitized Memory Clinic, for the diagnostic pathway of neurodegenerative dementias that incorporates digital health technologies with currently available assessment tools, such as fluid and imaging biomarkers, in an interplay with the physician. The Digitized Memory Clinic will manage people across the entire disease spectrum, from the detection of risk factors for cognitive decline and the earliest symptoms to dementia, and will replace the present paradigm of a pure 'brick-and-mortar' memory clinic. Important ethical, legal and societal barriers associated with the implementation of digital health technologies in memory clinics need to be addressed. The envisioned Digitized Memory Clinic aims to improve diagnostics and enable precise disease-tracking prognostication for individuals with memory disorders and to open new possibilities, such as precision medicine for prevention and treatment.
人口老龄化、劳动力减少以及阿尔茨海默病治疗新突破的实施等诸多挑战，促使人们必须重新思考如何诊断和治疗神经退行性痴呆患者。数字健康技术可以在这一转变中发挥关键作用，新的进展可以从单个个体收集数百万个数据点。可能的应用包括通过非侵入性监测来帮助早期发现疾病和基于人工智能的健康建议。为了将这些进展转化为对患者的真正益处，技术必须在一个系统中实施，该系统保留医生作为决策的核心人物。本文提出了一个新的框架，称为数字化记忆诊所，用于神经退行性痴呆的诊断途径，将数字健康技术与目前可用的评估工具（如液体和成像生物标志物）相结合，与医生一起相互作用。数字化记忆诊所将管理整个疾病谱的患者，从认知能力下降和早期症状到痴呆的危险因素检测，取代目前纯粹的“实体”记忆诊所模式。需要解决与数字健康技术在记忆诊所中的实施相关的重要伦理、法律和社会障碍。所设想的数字化记忆诊所旨在改善诊断，为记忆障碍患者提供精确的疾病跟踪预测，并为预防和治疗提供新的可能性，如精准医学。
