从早期检测到疾病修饰：为阿尔茨海默病管理的未来做准备

From Early Detection to DiseaseModification: Preparing for the Future ofAlzheimer’s Disease Management Key takeaways from the IQVIA Webinar PROFESSOR VANESSA RAYMONT, Dementias Platform UK and University of OxfordDR. JILL RASMUSSEN, Primary care specialist; Independent consultant at psi-napseDR. AMIR GLIK, Clinical neurologist; Chief Medical Officer at ALZAI HealthDR. STELLA KARANTZOULIS, Clinical neuropsychologist; Patient Centered Solutions, Global CNSPractice Lead, IQVIAFINLAY MACDOUGALL, Senior Principal, Neurology Real-World Networks & Partnerships, IQVIAJIE YEAP, Manager, Neurology Real-World Networks & Partnerships, IQVIAYUANYUAN CHEN, Intern, Genomics and Precision Medicine, IQVIA Table of contents Executive summary1The changing landscape of Alzheimer’s disease1Primary care at the forefront of dementia detection2Leveraging population-level predictive models to identify at-riskindividuals for Alzheimer’s disease3Rethinking how we measure outcomes3From innovation to implementation4A collaborative path forward for the management of Alzheimer’s disease5 Executive summary The field of Alzheimer’s Disease (AD) is at a turning point, as disease-modifyingtherapies and next-generation diagnostics reshape both research and clinicalcare. IQVIA’swebinarbrought together leading voices to discuss what theseinnovations mean for clinical practice and how to ensure healthcare systemsare ready to adapt. •Advances in therapies and diagnostics are offeringpromises of earlier intervention and improvedoutcomes in Alzheimer’s disease, with the greatestimpact when applied in the earliest stages The changing landscape ofAlzheimer’s disease Prof. Vanessa Raymont (Dementias Platform UK) startedthe session by reflecting on the remarkable progressin Alzheimer’s disease clinical research over the pastdecades. She noted that up to 45% of dementia casesmay be preventable through addressing modifiablerisk factors. This effort will be accelerated by the arrivalof disease-modifying therapies, and breakthroughsin blood-based biomarkers could enable earlieridentification of at-risk individuals. As understandingdeepens, it’s clear that AD begins long before symptomsappear — sometimes decades earlier. This insight isreshaping priorities, pushing diagnosis and treatmentupstream to preclinical and prodromal stages whereinterventions may have the greatest impact. •Primary care and AI-driven risk models areincreasingly central to identifying at-risk individualsand supporting proactive management, helping torealise the full potential of these advances •There is a critical need for more sensitive, reliable,and scalable Clinical Outcome Assessments (COAs),as existing measures are often burdensome andinsufficiently sensitive for early disease, limiting theirability to easily capture the full spectrum of patientexperience and disease progression •Piloting innovations in real-world healthcare settingsthrough implementation science is essential tointegrating new tools into clinical workflows whileoptimising the allocation of healthcare resourcesacross the AD care pathway. This supportshealthcare system readiness as earlier riskidentification scales Yet challenges persist: diagnosis rates remain low, andcare providers will need greater support and resourcesto harness early clinical markers effectively. Currently,biomarkers are primarily tested in symptomaticpatients in clinical care, and there’s limited evidenceon how these tests perform in those who are inpreclinical stages of the disease. As more individualsare identified as at risk or in early stages, healthcaresystems must develop new ways to support them notonly through access to emerging drug therapies, butalso comprehensive approaches to risk management,ongoing monitoring, education, and psychosocial careto address the broader needs of patients and theirfamilies throughout the disease continuum. The field isat a critical inflection point — promising, but dependenton coordinated actions. Alzheimer’s disease begins decadesbefore symptoms appear — shiftingdiagnosis and treatment upstream isno longer optional, but essential. settings and could be readily identified through analysisof electronic patient records. Digital technologies and AIare expected to support this shift by helping cliniciansidentify such risks without adding to their workload.This approach would enable clinicians to addressdementia risk alongside other health factors, makingprevention and early intervention a standard part ofeveryday care and catching cognitive decline earlier. shorten the patient journey and ensure that disease-modifying therapies reach those who need themsooner, thereby realising the full potential of emergingAlzheimer’stherapies. Rethinking how wemeasure outcomes Closing the diagnosis gap will require more than newtechnology. Primary care teams need education,resources, and system-level support to confidently useemerging tools and adapt to expanded responsibilities.Overcoming stigma and hel