Perspectives and challenges in patient stratification in Alzheimer's disease

被引：46

作者：

Abdelnour, Carla ^{[1
]}

Agosta, Federica ^{[2
,3
]}

Bozzali, Marco ^{[4
]}

Fougere, Bertrand ^{[5
]}

Iwata, Atsushi ^{[6
]}

Nilforooshan, Ramin ^{[7
,8
,9
]}

Takada, Leonel T. ^{[10
]}

Vinuela, Felix ^{[11
]}

Traber, Martin ^{[12
]}

机构：

[1] Univ Autonoma Barcelona, Barcelona, Spain

[2] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Unit Neurol, Milan, Italy

[3] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Neuroimaging Res Unit, Milan, Italy

[4] Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy

[5] Tours Univ Hosp, Dept Geriatr Med, Tours, France

[6] Tokyo Metropolitan Geriatr Hosp, Dept Neurol, Tokyo, Japan

[7] Surrey & Borders Partnership NHS Fdn Trust, Abraham Cowley Unit, Chertsey, England

[8] Univ Surrey, Guildford, Surrey, England

[9] Care Res & Technol Ctr, UK Dementia Res Inst, London, England

[10] Univ Sao Paulo, Dept Neurol, Cognit & Behav Neurol Unit, Sao Paulo, Brazil

[11] Univ Seville, Hosp Victoria Eugenia, Unidad Deterioro Cognit, Inst Neurol Andaluz,Hosp Virgen Macarena,Fac Med, Seville, Spain

[12] F Hoffmann La Roche Ltd, Prod Dev Med Affairs, Basel, Switzerland

来源：

ALZHEIMERS RESEARCH & THERAPY | 2022年 / 14卷 / 01期

关键词：

Alzheimer's disease; Patient stratification; Biomarkers; Mild cognitive impairment; Precision medicine; Early diagnosis; Disease-modifying therapy; Dementia; Stigma; Cultural perceptions of dementia; MILD COGNITIVE IMPAIRMENT; NEUROIMAGING BIOMARKERS; DEMENTIA; SCORES; RISK; CARE;

D O I：

10.1186/s13195-022-01055-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background Patient stratification is the division of a patient population into distinct subgroups based on the presence or absence of particular disease characteristics. As patient stratification can be used to account for the underlying pathology of a disease, it can help physicians to tailor therapeutic interventions to individuals and optimize their care management and treatment regime. Alzheimer's disease, the most common form of dementia, is a heterogeneous disease and its management benefits from patient stratification in clinical trials, and the development of personalized care and treatment strategies for people living with the disease. Main body In this review, we discuss the importance of the stratification of people living with Alzheimer's disease, the challenges associated with early diagnosis and patient stratification, and the evolution of patient stratification once disease-modifying therapies become widely available. Conclusion Patient stratification plays an important role in drug development in clinical trials and may play an even larger role in clinical practice. A timely diagnosis and stratification of people living with Alzheimer's disease is paramount in determining people who are at risk of progressing from mild cognitive impairment to Alzheimer's dementia. There are key issues associated with stratifying patients which include the heterogeneity and complex neurobiology behind Alzheimer's disease, our inadequately prepared healthcare systems, and the cultural perceptions of Alzheimer's disease. Stratifying people living with Alzheimer's disease may be the key in establishing precision and personalized medicine in the field, optimizing disease prevention and pharmaceutical treatment to slow or stop cognitive decline, while minimizing adverse effects.

引用

页数：12

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