This year’s Alzheimer’s Association International Conference (AAIC) in Philadelphia, from July 28th to August 1st, promises an exciting showcase of breakthroughs in the fight against Alzheimer’s disease. Leading experts, healthcare providers, researchers, patients, and advocates will converge to discuss significant progress, including novel diagnostics and therapeutics reaching regulatory milestones. With healthcare systems’ readiness to deliver these innovations in focus, the conversation has never been more vital.
The rise of the prevalence and growing global burden of Alzheimer’s and dementia underscore the importance of expanding access to the early detection of cognitive impairment in primary care. Globally, systems will go further and faster by learning from one another. That’s the focus of the Davos Alzheimer’s Collaborative (DAC) Healthcare System Preparedness program – translating research breakthroughs to clinical practice through rigorous implementation strategies – which will be working with 49 sites across 18 countries by the end of the year.
Our programs focus on understanding the key barriers and facilitators to the adoption of novel diagnostics in the Alzheimer’s Disease care pathway globally. Utilizing implementation science, the systematic study of increasing uptake of novel health interventions, we have partnered with global health systems to document the challenges of implementing novel diagnostic tools in primary care to clarify the changes to clinical practice, health system operations, and policy required to ensure broad access to these important novel innovations. The innovations deployed in our studies include retinal scans, digital cognitive assessments, and/or blood biomarkers across countries such as the US, Japan, Germany, Brazil, Kenya, Armenia, Jamaica, Scotland and other places.
Last year, we shared interim learnings from 19 sites, documenting mid-point learnings on barriers and opportunities to the implementation of early detection in primary care. This year, we are excited to share some of the emerging summative results of the program. Specifically, we will share posters, and research findings from our health system partners, and cross-site analysis driven by the DAC team. Some of DAC’s readouts at AAIC include:
- A Blueprint for Early Detection of Cognitive Impairment: A Roadmap for Global Healthcare System Readiness. This poster provides an overview of an innovative tool to guide implementation co-designed with the site leaders of seven of our programs. It should be of interest to clinicians and leaders seeking to implement early detection in their own systems.
- Lessons Learned from a Global Multisite Early Detection Program in Primary Care Implementation Program. This poster provides cross-site themes on program implementation and connects outcomes at the site of care to the operational context and policy environments of global health systems.
- Global Effort to Improve Healthcare System Readiness for Early Detection of Cognitive Impairment: A Davos Alzheimer’s Collaborative Initiative. This Featured Research Session will be an interactive discussion from six global site leaders sharing insights from implementing early detection programs, including opportunities for adoption and scalability, as well as sustainable change within and across healthcare systems.
While these programs were implemented in markedly different contexts globally, there are some clear cross-cutting themes. Firstly, it is feasible to implement early detection programs in primary care through the use of novel tools, including digital cognitive assessments and blood biomarkers. Secondly, across countries, primary care physicians are incentivized to work in their practice, not on their practice, and there are significant operational barriers related to IT resources, reimbursement and procurement, and change management that can be solved by effective champions with the mandate and resources to do so. Finally, changes to health system operations are critical to ensuring medical education is effective and connects to changes in attitudes and behavior. From our Armenian program that transports clinicians via van to hard-to-reach areas, to our Toronto retinal screenings that lean on coordinated care with optometrists, to our US and Japanese community-based pharmacy initiatives, our flagships sites and grant recipients showcase the ways that unique challenges can have unique solutions.
This is a particularly critical time. With newly approved disease-modifying therapies, and preventative treatments in the pipeline, there’s more momentum than ever. But behind the scenes, we’re laying the groundwork to revolutionize healthcare systems, confronting the disease with new strategies and tools at earlier stages, with greater reach to patients, for real-world impact.
My DAC colleagues will share their experiences focused on expanding inclusive research to low and middle-income regions. The global cohort team engages with large-scale digital cognitive assessment data (speech, ocular, olfactory) and bio-samples (blood, saliva) in India, Egypt, Kenya, South Korea, Malaysia, Caribbean countries and Chile. The team is also working to validate and localize the first digital tools in East Africa with the Aga Khan University, marking a significant step towards improving access to early detection in underserved regions.
What’s next for DAC and the field? In conjunction with our site partners, we have more than 15 manuscripts from our Early Detection program in progress and by the end of 2024, we will have launched four new programs.
- Accurate diagnosis an eight-site, five-country program to translate research breakthroughs in blood biomarkers into routine clinical practice in both primary and specialty care
- US Healthcare System Fellowship will see 10 healthcare systems implement the Early Detection Blueprint in their settings to expand access to early detection in the US and evaluate, improve and tailor the Early Detection Blueprint to the US context
- The US Brain Health Navigator program which will see up to 6 US sites, will co-design and pilot a brain health navigator model for broad dissemination
- Additionally, we’re supporting the Innovative Health Initiative AD-RIDDLE consortium, a new interdisciplinary initiative to revolutionize the way Alzheimer’s disease is detected, diagnosed, prevented, and treated across 8 sites in the EU and UK
The field of Alzheimer’s research has new hope and promise as groundbreaking diagnostics, innovative technologies, and effective treatments are becoming available. These advancements offer opportunities for early detection and improved patient outcomes, marking a transformative era in the fight against Alzheimer’s disease.
Tim MacLeod
Dr. Tim MacLeod is the director of the Davos Alzheimer’s Collaborative Healthcare System Preparedness program.
