Integrating Pathological Diagnosis And Clinical Staging With Advances In AD Biomarkers

Abstract Background The Alzheimer’s disease (AD) treatment landscape is evolving with new approaches to diagnosis and treatment. Phenotype only diagnosis is incorrect in almost one-third of cases, so biomarker-supported diagnosis is essential for timely and accurate diagnosis of AD. This talk will focus on the application of fluid biomarkers, including cerebrospinal fluid (CSF) analysis and emerging blood-based tests like plasma p-tau217. Biomarkers are essential for confirming the presence of amyloid pathology and guiding treatment options. This presentation will discuss the updated diagnostic criteria for Alzheimer’s disease and how these criteria are incorporated into clinical practice. Methods We will present data from a recent published review on new horizons for diagnostic and therapeutic opportunities in AD clinical practice. We will discuss what the future landscape looks like for biomarker supported diagnosis and prognosis of AD in clinical settings. We will report on the results of real-world clinical validation studies of blood based biomarkers in memory clinical settings. We will report on Irish multidisciplinary consensus guidelines on the application of biomarkers in memory services. Results We will present on clear pathways within the evolving model of care which support the integration of fluid biomarkers in the diagnosis of AD. Blood based biomarkers (plasma p-tau217) demonstrated strong diagnostic performance for AD with an AUC of 0.91, highlighting its potential as a practical diagnostic tool in memory clinic settings. Irish consensus guidelines support the appropriate use of CSF biomarkers in AD diagnosis, and discuss potential structure for roll-out of blood-based biomarkers. Conclusion Timely and accurate AD diagnosis is essential to support individuals to live as well as possible after diagnosis. Advances in fluid biomarkers will ensure diagnostic certainty for patient and clinicians, but will need careful integration into clinical practice.