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- W4323051777 abstract "BackgroundThe NIA-AA research framework proposes a purely biological definition of Alzheimer’s Disease (AD). This implies AD can be diagnosed based on biomarker abnormalities, regardless of clinical expression. While this brings opportunities, it also raises challenges. We aimed to provide an overview of considerations regarding the disclosure of AD pathology before the onset of dementia.MethodsA systematic literature review was conducted according to PRISMA guidelines. We searched PubMed, Embase, APA PsycINFO and Web of Science Core Collection (on 10 December 2020) for references on conveying AD biomarker results to individuals without dementia. Our query combined variations on the terms Alzheimer’s Disease, disclosure, or diagnosis, preclinical or prodromal, and biomarkers. Two reviewers independently screened the resulting 6860 titles and abstracts for eligibility and examined 162 full text records for relevance. We included theoretical articles in English, on communicating amyloid and/or tau results to individuals with mild cognitive impairment, subjective cognitive decline, or normal cognition. MAXQDA-software was used for inductive data analysis.ResultsWe included 27 publications. From these we extracted 26 unique considerations, which we grouped according to their primary relevance to a clinical, personal, or societal context. Clinical considerations included (lack of) validity, utility, and disclosure protocols. Personal considerations covered psychological and behavioral implications, as well as the right to (not) know. Finally, societal considerations comprised the risk of misconception, stigmatization, and discrimination. Overall, views were heterogeneous and often contradictory.ConclusionPerspectives on diagnosing AD before dementia vary widely. The theoretical literature tended to focus on adverse impact and rely on common morality, while the motivation for and implications of biomarker testing are deeply personal. Our Findings: provide a starting point for clinicians to discuss biomarker-based diagnosis with their patients, which will become even more relevant since the conditional approval of a first disease-modifying drug for AD." @default.
- W4323051777 created "2023-03-04" @default.
- W4323051777 date "2023-04-01" @default.
- W4323051777 modified "2023-09-30" @default.
- W4323051777 title "Considerations regarding a diagnosis of Alzheimer’s Disease before dementia: a systematic review" @default.
- W4323051777 doi "https://doi.org/10.1016/j.pec.2022.10.066" @default.
- W4323051777 hasPublicationYear "2023" @default.
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