Advancing Patient Care
Clinical research demonstrates the value of early detection of dementia, including dementia caused by Alzheimer’s disease (AD) and related disorders. Yet, timely and accurate diagnosis of AD in clinical practice remains challenging. The most widely used biomarkers to aid diagnosis of AD are positron emission tomography (PET) scans and cerebrospinal fluid (CSF) biomarkers. However, the clinical community recognizes that these tests have some limitations. Blood tests, also known as blood-based biomarkers (BBMs), are emerging as an aid for detecting and diagnosing AD. These include tests that measure circulating levels of amyloid or phosphorylated tau protein.
Clinician Awareness, Attitudes, and Interest in Blood Tests for Alzheimer’s Disease
Insights from compatible surveys issued by the American Academy of Family Physicians (AAFP) and the Gerontological Society of America (GSA)
The Global CEO Initiative on Alzheimer’s Disease (CEOi) is leading a global effort to prepare for the widespread adoption of BBMs for diagnosis of AD into clinical practice. As part of this effort, CEOi commissioned AAFP and GSA to issue surveys to their members in May and June 2024 to explore current perceptions and experience with BBM1 testing. Members were also asked to share their thoughts on how BBMs might be used in clinical practice and what is needed to strengthen their knowledge about BBMs.
1Limited Access to Existing Tools
Constrains Patient Diagnosis
Clinicians lack confidence that patients can receive timely access to current testing methods (i.e., CSF and PET tests).
Only 11% of AAFP respondents and 24% of GSA respondents were confident or highly confident that patients could receive an amyloid PET scan or lumbar puncture for CSF biomarkers within 6 months.
Confidence That Patients Could Receive Amyloid PET Scan or Lumbar Puncture For CSF Biomarkers Within 6 Months
Blood Test for Alzheimer’s Disease Seen as Major Opportunity
Clinicians see great opportunity with using BBMs. While challenges exist, there are several benefits of BBMs compared with existing tools. 100% of AAFP respondents and 94% of GSA respondents see themselves using BBMs in the future. Nearly half of the AAFP respondents see themselves using BBMs frequently.
Expected Future Use of BBMs for AD
“I feel as though the field is exploding with different biomarkers and I am not really sure which ones are legitimate or helpful.”
—AAFP respondent
Existing Experience With BBMs For Diagnosing AD
Despite the future potential, few clinicians have experience with the use of BBMs for diagnosing AD. The majority of respondents from both organizations have no experience with them to date.
Existing Experience with BBMs for Diagnosing AD
Perceived Challenges and Barriers to BBM Adoption
AAFP and GSA respondents considered a number of potential challenges regarding why adoption of BBMs could be limited.
Several common issues were ranked highly in both organizations, including lack of information on how to interpret results and lack of evidence for the tests. Reimbursement, ordering, and communication challenges were also cited. Top 5 Challenges to Patients Receiving BBM Tests 1 2 3 4 5
Respondents
5
Clinicians See Several Advantages for BBMs
for PCPs/FPs
Despite these barriers, there are a number of advantages to using BBMs to diagnose AD.
Helps identify the most appropriate patients for referral to dementia specialists
Faciliates earlier access to disease-modifying treatment
Respondents highlighted the value of having quantifiable biological data to complement other assessments, the opportunity to facilitate access to new disease-modifying therapies, and the benefit of facilitating earlier conversations with patients as key features.
Perceived to be less expensive / more accessible / less invasive than existing tests (CSF/PET)
Education Will Be Key to Driving Adoption of BBMs
Clinicians are eager to learn more about using BBMs as an aid to diagnose or as a tool to triage for further testing.
Education about test selection criteria and test characteristics was rated as an area of greatest interest, while learning about how tests fit into diagnosis and care pathways was second for both groups.
Conclusions
BBMs are perceived by clinicians to have significant potential in diagnosing AD. Clinicians would be most likely to employ BBM tests if there were:
• Validation of test accuracy and evidence to use the tests.
• Clarity on how to interpret test results and communicate them to patients.
• Education on how to use the
for clinicians to maintain continuity of care for patients with co-morbidities
Preferred Methods For Learning More About BBMs
Online or virtual Continuing Medical Education (CME) was ranked as the top mechanism for learning more about BBMs, with in-person CME and journal publications also ranked highly.
for their patients.
