“Knowing what you face helps with planning, getting the right medication, care and support. It also helps you and your family prepare for the road ahead.” - Alzheimer Society of Canada
Introduction to IMPACT-AD
Currently, there are over seven hundred thousand Canadians living with Alzheimer’s disease or a related form of dementia. For this group, the value of biomarker testing in aiding with the diagnostic process is recognized internationally; however, there exist barriers to implementation in routine care in Canada. A new Canada-wide study led by scientists at UBC – IMPACT-AD (impactAD.org) – aims to bridge this gap between diagnostic accuracy studies and clinical utilization of Alzheimer’s disease biomarkers in Canada. The study will evaluate the impact of Alzheimer’s disease biomarker testing on diagnosis and medical management, health economics and personal utility, with the ultimate goal of informing positive change in the health care system..
Diagnostic approaches to Alzheimer’s disease
Current approaches in Canada for Alzheimer’s disease diagnosis rely on traditional imaging tests and observation of the signs and symptoms of the disease; however, adding the measure of proteins found in cerebrospinal fluid (i.e. biomarkers amyloid-beta and tau) has been shown, in certain settings, to improve diagnostic accuracy and predict those with mild symptoms that are likely to progress to dementia. As such, in many countries, measuring amyloid-beta and tau is now routine practice.
IMPACT-AD leverages the work done in the clinical laboratory at St Paul’s Hospital, under the direction of IMPACT-AD principal investigator Dr. Mari DeMarco, to develop clinical quality testing for these key biomarkers. As Dr. DeMarco explains, “A stumbling block in doctors getting access to this type of testing in Canada was the availability of diagnostic tools appropriate for use in tightly regulated medical environments. Via our group’s expertise in diagnostic tool development, we addressed this initial barrier by building Alzheimer’s disease tests suitable for use in patient care.”
The impact of timely diagnosis
The Alzheimer Society of Canada has found that half of Canadians affected by dementia dismiss early signs of the disease and live with their symptoms for at least a year before seeking medical attention. It is known that receiving a diagnosis facilitates effective and efficient healthcare interventions, and it is central to effective and efficient community services for dementia for both patients and their caregivers. This is why the World Health Organization has identified obtaining a confident diagnosis as the critical point in their 7-stage model for planning of dementia services.
Individuals with Alzheimer’s disease and their families face personal and financial challenges from providing health and social care and from reduction or loss of income. The earlier a diagnosis is made, the more time the individual affected can participate in the planning process, and the better the entire family can prepare for living with the disease. From the health and social system perspective, integrated and coordinated health and social services are needed to respond to the changing needs of individuals with Alzheimer’s disease and their caregivers; however, accurate systems forecasting requires early and accurate diagnosis.
IMPACT-AD team & partners
IMPACT-AD’s multidisciplinary team includes laboratory medicine specialists, geriatricians, neurologists, health economists, rural/remote clinicians, ethicists, statisticians, key stakeholder groups (e.g. Alzheimer Society, Canadian Consortium on Neurodegeneration in Aging), and, critically, individuals living with Alzheimer’s disease and their families/caregivers. The study is based at St. Paul’s Hospital and is led by Dr. DeMarco, a Clinical Chemist at St. Paul’s Hospital and Clinical Associate Professor in Pathology and Laboratory Medicine at UBC. The team includes several UBC faculty that are experts in dementia care and research – Dr. Robin Hsiung, Dr. Haakon Nygaard, Dr. Howard Feldman, Dr. John Best and Dr. Jacqueline Pettersen – as well as national and international experts in personhood and care in dementia.
This study is now underway with the generous support of Brain Canada, the Michael Smith Foundation for Health Research, the UBC Faculty of Medicine and the Djavad Mowafaghian Centre for Brain Health, and the Women's Brain Health Initiative.
For more information about the study and how you can get involved, visit: impactAD.org