Leading Alzheimer's disease experts at this year's Alzheimer Europe Conference, in partnership with Eli Lilly and Company, have called for urgent improvements to diagnostic pathways to ensure people in Europe can benefit from new therapeutic innovation.
Based on the findings drawn from the Adelphi Real World Dementia Disease Specific Programme (Adelphi DSP) - a multinational and cross-sectional survey of clinicians treating patients with mild cognitive impairment (MCI) and AD patients in France, Germany, Italy, Spain, the United Kingdom, Japan, and the United States - experts warn that AD and dementia remain critically underdiagnosed, denying patients the opportunity to access treatment and care options.
A study published in The Lancet further highlights that while new therapies in Alzheimer's disease (AD) are emerging with levels of clinical meaningfulness, efficacy, and safety comparable to treatments for cancer, multiple sclerosis, and rheumatoid arthritis, further consideration must be given to care models and funding to improve equitable access for people with AD to innovative therapeutic options. This reflects a broader disparity in how innovation is made available across diseases within the context of modern personalised medicine.
"We find ourselves at a critical moment, where the decisions made now will shape the future of AD care in Europe," reflected Professor Lutz Frölich, Head of the Department of Geriatric Psychiatry, Central Institute of Mental Health and Full Professor, Medical Faculty Mannheim, University of Heidelberg, Germany. "Science has equipped us with the solutions to manage AD more effectively in its early stages, potentially reducing the disease burden. But this will only be possible if we can streamline diagnosis and make access to care timely and equitable for everyone affected by this progressive disease."
Alzheimer's disease currently affects approximately 6.9 million people in Europe, with this figure expected to almost double by 2050 as aging populations continue to increase.
Limited access to biomarker testing was identified as a key barrier to timely diagnosis in the Adelphi DSP Survey. Biomarker tests, which detect abnormal changes in the brain, play a vital role in enabling rapid and accurate AD diagnosis in its earliest stages. Despite over 70% of clinicians rating these biomarker tests important or extremely important, they remain underutilized in practice. Across the countries studied, fewer than one in five patients (15.2%) received biomarker testing to confirm the specific pathology. At a country level, patients in Germany and the UK were the least likely to receive these tests.
"These findings paint a deeply concerning picture of AD diagnosis across Europe and are sadly reflective of the experiences of many patients and families we support, who are often left too long without answers," said Jean Georges, Executive Director, Alzheimer Europe. "A carers' survey conducted in 2018 by our organization in the Czech Republic, Finland, Italy, the Netherlands, and the UK, found that the time to diagnosis from first symptoms took on average 2.1 years and 53% of carers felt that the diagnosis was made too late. If we want to ensure that people receive a timely diagnosis and support when it matters most, we need to implement the lessons from this research urgently and recognise AD as a policy priority, raise public awareness and combat stigma, increase medical training and the number of needed specialists, and improve access to innovative testing."
"Emerging therapies that target the pathology of Alzheimer's disease offer hope to slow progression and delay the need for care services. But this possibility hinges on early detection, as approximately one-third of individuals in early symptomatic stages of the disease will progress to more advanced clinical stages within one year,” adds Dr Stéphane Epelbaum, Associate Vice President, International Medical Affairs at Eli Lilly. "Timely and accurate diagnosis is essential to ensure patients can access the next generation of Alzheimer's disease care."