Timely Diagnosis for Alzheimer's Disease: A Literature Review on Benefits and Challenges.
BACKGROUND
Timely diagnosis of Alzheimer's disease (AD) refers to a diagnosis at the stage when patients come to the attention of clinicians because of concerns about changes in cognition, behavior, or functioning and can be still free of dementia and functionally independent.


OBJECTIVE
To comprehensively review existing scientific evidence on the benefits and potential challenges of making a timely diagnosis of AD.


METHODS
Relevant studies were identified by searching electronic databases (Medline, Embase) and bibliographies for studies published in English between 1 January 2000 and 2 June 2014 on the consequences of a timely diagnosis of AD.


RESULTS
Nine studies were identified that investigated the consequences of diagnosing AD at the initial stages; none were specifically focused on prodromal AD. A timely diagnosis potentially offers the opportunities of early intervention, implementation of coordinated care plans, better management of symptoms, patient safety, cost savings, and postponement of institutionalization. Barriers to making a timely diagnosis include stigma, suicide risk, lack of training, diagnostic uncertainty, shortage of specialized diagnostic services, and the reluctance of healthcare providers to make a diagnosis when no effective disease-modifying options are available.


CONCLUSIONS
Despite its potential benefits, few published studies have explored the advantages or risks of a timely diagnosis of AD. In light of the cultural shift toward diagnosis at the initial stage of the disease continuum, when the patient does not yet have dementia, more investigations are needed to evaluate the benefits and address the barriers that may impede making a timely AD diagnosis.
Institute for Memory and Alzheimer's disease (IM2A) and ICM, Salpêtrière University Hospital, Paris University, France.
Bruno
B
Dubois
Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
Alessandro
A
Padovani
Department of Neurology and Alzheimer's Center, VU University Medical Center, Amsterdam, The Netherlands.
Philip
P
Scheltens
Eli Lilly Italia S.p.A, Sesto Fiorentino (FI), Italy.
Andrea
A
Rossi
Eli Lilly Italia S.p.A, Sesto Fiorentino (FI), Italy.
Grazia
G
Dell'Agnello
D000544:Alzheimer Disease / Q000175:diagnosis*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D013997:Time Factors
Alzheimer’s disease; diagnosis; pre-dementia; review; timely