Transforming Alzheimer's care by bringing diagnosis to the household and primary care
In the first installment of theses interview series, we speak with Dag Aarsland, Professor of Old Age Psychiatry at King's College London and research lead at Stavanger University Hospital. Dag is the academic lead in PREDICTOM and coordinator of its clinical trial. He explains: 'As PREDICTOM's scientific lead, I make sure the scientific activities in the project are running smoothly. I also try to detect any issues we face early on and solve any bottlenecks that come up.'
As we are wrapping up the first year of PREDICTOM's activities, we reflect on our achievements to date and look ahead at upcoming collaborations. In the following interview series, we introduce PREDICTOM's leaders with their work and ambitions for the project as well as their vision for its potential impact.
In PREDICTOM, researchers from academia and industry are working together to develop an AI driven screening platform for early prediction of Alzheimer's disease (AD). The aim of the project is to find new markers and signs that can be used to identify people with a higher risk of developing AD.
Alzheimer's disease care under high pressure
Alzheimer’s disease is a complicated condition where damaged brain cells cause loss of brain function. Once the brain cells are damaged, the damage cannot be undone. At the moment, there is no cure, and early diagnosis is difficult.
‘The earlier we diagnose Alzheimer's, the better we can develop treatment options. That is why we need to identify people at risk for developing Alzheimer’s quicker since this will enable us to intervene more effectively and delay the disease progression’, says Dag.
Currently, diagnosis of AD is performed at already overloaded specialist clinics. The number of people with AD is expected to rise significantly in the coming years, which will put even more pressure on the healthcare system. Other initiatives, such as PROMINENT and AD-RIDDLE, are also searching for new biomarkers to detect AD.
‘What makes PREDICTOM unique is that we try to find easy and accessible diagnostic tools that can be applied in the household and at the general practitioner’s level’ - Dag elaborates. Bringing diagnosis to the household and primary care will relieve pressure from the clinics and from the healthcare system overall.
Professor Dag Aarsland
Photo: Frida Moberg, Stavanger University Hospital
Sharing data via PREDICTOM's platform
‘In PREDICTOM we will develop new markers and signs to identify those people who have or are at risk of developing AD. The new insights from the biomarkers will be analyzed with AI and stored in a database. The databased can be used by citizens, doctors, and researchers’, Dag explains further.
Citizens who have not yet been diagnosed or feel worried about their health, can use PREDICTOM's platform to complete an online self-assessment. The self-assessment will give an indication of their likeliness to develop AD. ‘Of course, citizens are always advised to consult a healthcare professional’, Dag highlights.
Healthcare professionals in primary care (general practitioners), as well as specialists in memory clinics can use the platform developed by PREDICTOM to aid them in their diagnostic efforts. Moreover, other researchers can re-use the data, with the appropriate data sharing privacy and usage guidelines.
Working towards starting the PREDICTOM clinical trial
One year after the official start of PREDICTOM, its consortium members recently gathered for a second general assembly in Erlangen, Germany, to discuss work progress and plans for collaboration. Dag reflects back on that meeting with a positive look: ‘The atmosphere at the general meeting was excellent. I think the plan we developed is really good’.
However, the project faces certain challenges. ‘A major challenge for us’, says Dag, ‘is to maximize used time on research, instead of on administrative tasks. For example, we needed to obtain approval from national ethical boards to kick-off the clinical trial. For that, we encountered different procedures in each participating country. This made the process difficult and time-consuming. A centralized ethics approval committee would greatly support future research endeavors.
Fortunately, we have been successful and received approval to start collecting the data in Norway and the UK.’ In the clinical trial, we aim to recruit 4000 participants identified from earlier initiatives (PROTECT, RADAR-AD) who will test the diagnostic tools and biomarkers developed in PREDICTOM.
Looking for synergy
Dag highlights the importance of collaborating with similar initiatives: ‘At the 34th Alzheimer Europe conference in Geneva, I partook in a panel discussion with members from two other IHI initiatives, PROMINENT and AD-RIDDLE. To maximize our societal impact, it is crucial that we work together and coordinate our activities so as to ensure minimum overlap and maximize efficiency.’
Apart from sharing the same goals, these projects are also public-private partnerships in nature. Such collaborations bring academia and industry together. On the significance of these collaborations Dag comments: ‘Working together is useful for industry, but also beneficial for the clinic and academia. We have a lot to learn from each other and we need each other in order to reach our goals.’
Changing the healthcare system
PREDICTOM will transform Alzheimer's care by developing facile collection and analysis of biomarkers for earlier detection of AD. In that way, diagnosis shifts from the specialist's clinic to the household and the general practitioner. This will relieve pressure from the specialist clinics and reduce costs. Besides saving costs, early diagnosis will also help develop new treatments procedures.
‘Medication aside, people themselves can change their habits to improve their quality of life’, emphasizes Dag. ‘More exercise and constantly learning new things can have major positive influence on the progression of AD. Earlier diagnosis will make people realize that something is going on, which will hopefully increase their motivation to make these lifestyle changes.’
