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Diagnosis of hidden Alzheimer’s disease

A significant proportion of patients with Alzheimer’s disease (AD) remains undiagnosed or diagnosed at a late stage. Through a series of initiatives, the MOPEAD project aims to contribute to its timely diagnosis.

Health

Emerging evidence indicates that early AD diagnosis offers an optimal opportunity for intervention, leading to significant health, social and economic benefits.

Dementia prescreening tools

The EU and industry-funded MOPEAD project designed four prescreening strategies to unveil dementia hidden cases and raise awareness in the general public and health professionals on the importance of early diagnosis of cognitive impairment. “The initiatives were designed to be complementary, targeting different populations,” explains project coordinator Mercè Boada. These activities included a web-based initiative for the identification of individuals at risk of dementia and an open house memory clinic accessible to anyone worried about their memory. The project also developed protocols for the early detection of cognitive decline at primary care practices or diabetologist tertiary units. Individuals identified through these initiatives with a risk of dementia underwent a harmonised evaluation to obtain an accurate clinical diagnosis. As envisaged, population-based initiatives enrolled younger individuals with better cognitive status compared to patient-based strategies at primary care or diabetic clinics. The proportion of positive prescreening results reflected this observation with the web-based initiative exhibiting 36 % of positive cases compared to the diabetic clinic initiative that showed 58 % positive individuals. Following clinical evaluation of the positive cases from the diabetic clinic, 84 % of the cases were confirmed. Interestingly, the number of individuals who participated in the web-based initiative alone was greater than the sum of all other initiatives together. This clearly indicated the power of e-solutions in the healthcare of cognitive deficits. Nonetheless, the choice of the dementia prescreening strategy depends on the specific goals, the characteristics of the target population and available resources. “Although budget may pose a significant limitation to implementing a combination of these strategies, it is essential to overcome the problem of dementia underdiagnosis,” emphasises Boada.

MOPEAD impact on disease management

Worldwide, approximately 50 million people are living with dementia and the number is estimated to increase. Late diagnosis is associated with irreversible neuronal damage, for which there is no cure. Apart from the timely diagnosis of cognitive deficits, MOPEAD is expected to give access to treatments early on, including experimental protocols. Partners tested the MOPEAD strategies in five different European academic institutions, with varying outcomes. Efforts to standardise dementia early detection protocols across Europe will not only improve citizen health but also positively affect the overall quality of research in the field by facilitating patient recruitment in clinical trials. This increases the chances of finding new effective treatments. While population-based strategies have a great potential to prescreen large numbers of individuals, patient-based strategies reach individuals who regularly visit the health services and may be at greater risk of dementia. MOPEAD dissemination activities such as educational leaflets and infographics will definitively help increase awareness of the problem and improve disease management. By promoting a paradigm shift towards earlier dementia diagnosis, partners hope to overcome existing barriers that contribute to delayed diagnosis, including limited resources and stigmatisation.

Keywords

MOPEAD, dementia, diagnosis, prescreening, diabetic clinic, Alzheimer’s disease

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