期刊
JOURNAL OF ALZHEIMERS DISEASE
卷 90, 期 3, 页码 953-962出版社
IOS PRESS
DOI: 10.3233/JAD-220458
关键词
Alzheimer's disease; amyloid; biomarkers; dementia; genetics
资金
- Stanford Alzheimer's Disease Research Center [P30AG 066515]
- War Related Illness and Injury Study Center
- NIA [R01AG068206, P30AG066509, P30AG062421, P30AG072931, K0 1AG057796, U24AG041689, R56AG069130]
- State of Sao Paulo Research Foundation (FAPESP) [2015/101095]
- Office of Research and Development of the Department of Veterans Affairs [VISN 21 MIRECC, RX003152]
- Alzheimer's Association
- Doris Duke Charitable Foundation
- Humana Healthcare
- Eisai/Biogen
- Lilly
- Biohaven
- BrightFocus Foundation
- Eli Lilly
- Genentech
- Biogen
- SiteRx
- FAPESP -The State of Sao Paulo Research Foundation
The public is increasingly recognizing the value of accessing dementia risk evidence (DRE) as it can guide diagnosis and clinical management, while researchers are considering how to share and use this evidence.
The brain changes of Alzheimer's disease and other degenerative dementias begin long before cognitive dysfunction develops, and in people with subtle cognitive complaints, clinicians often struggle to predict who will develop dementia. The public increasingly sees benefits to accessing dementia risk evidence (DRE) such as biomarkers, predictive algorithms, and genetic information, particularly as this information moves from research to demonstrated usefulness in guiding diagnosis and clinical management. For example, the knowledge that one has high levels of amyloid in the brain may lead one to seek amyloid reducing medications, plan for disability, or engage in health promoting behaviors to fight cognitive decline. Researchers often hesitate to share DRE data, either because they are insufficiently validated or reliable for use in individuals, or there are concerns about assuring responsible use and ensuring adequate understanding of potential problems when one's biomarker status is known. Concerns include warning people receiving DRE about situations in which they might be compelled to disclose their risk status potentially leading to discrimination or stigma. The Advisory Group on Risk Evidence Education for Dementia (AGREEDementia) welcomes all concerned with how best to share and use DRE. Supporting understanding in clinicians, stakeholders, and people with or at risk for dementia and clearly delineating risks, benefits, and gaps in knowledge is vital. This brief overview describes elements that made this group effective as a model for other health conditions where there is interest in unfettered collaboration to discuss diagnostic uncertainty and the appropriate use and communication of health-related risk information.
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