The validity and impact of Alzheimer blood biomarker implementation at the primary care level

Recent breakthrough discoveries in Alzheimer biomarker research have yielded diagnostically accurate blood tests for Alzheimer diagnosis. In order to reach their full transformative potential, these blood biomarker assays may need to be implemented at the primary care level. As a necessary condition, more real-world evidence is needed with regards to their feasibility, acceptability and clinical utility at this level. This interdisciplinary proposal focuses on individuals above 55 years of age who consult their primary care physician for cognitive complaints. We will examine in which way implementation of the 217phosphotau Lumipulse assay at the primary care level alters the patient trajectory. In a first step we will clarify the current judgment and decision processes in a representative group of primary care practices when confronted with cognitive complaints. Secondly, we will evaluate how the test outcome influences the referral decision by the primary care physician and the further clinical management compared to current practice. Finally, within a subgroup we will examine how the test results relate to markers only available at the tertiary level, namely detailed cognitive assessments and biological Alzheimer staging.

Keywords:dementia diagnosis, prodromal Alzheimer, tau PET, Alzheimer fluid biomarkers, cognitive complaints, Alzheimer biological staging, Alzheimer diagnostic trajectory

Disciplines:Biomarker evaluation, Neurological and neuromuscular diseases, Primary health care