How can Alzheimer's disease blood‐based biomarkers reach clinical practice?

INTRODUCTION Alzheimer's disease (AD) diagnosis has been based largely on clinical symptoms, despite their limited sensitivity and specificity. Biomarker use was proposed to support a more accurate and timely diagnosis. However, neuroimaging or cerebrospinal fluid (CSF) is rarely used in primary care due to their perceived invasiveness, cost, and need for appropriate infrastructure. Blood-based biomarkers (BBMs) could represent an economical, minimally invasive alternative, but barriers exist to a seamless translation to the clinic.

METHODS Ten international experienced AD clinicians and biomarker experts participated in a diagnostic roundtable to discuss the implementation of BBMs for diagnosing early symptomatic AD.

RESULTS The participants proposed an optimal AD diagnostic pathway and highlighted three main gaps to implementing BBMs for early symptomatic AD diagnosis: limited real-world data, resource gaps, and system barriers.

DISCUSSION Although BBMs could streamline the AD diagnostic pathway, further real-world evidence and collaboration among multiple stakeholders are needed.

Highlights Early symptomatic Alzheimer's disease (AD) diagnosis improves treatment strategy and lowers costs. Currently available biomarkers are not widely used across all clinical settings. Blood-based biomarkers (BBMs) could be a cost-effective, minimally invasive alternative. BBMs could accelerate an accurate AD diagnosis. There are barriers to the inclusion of BBMs in clinical practice.