Jonsdottir, Maria, K., Harrison, John and Hannesdottir, Kristin (2023) The ambivalence towards neuropsychology in dementia research, diagnosis, and drug development: Myths and misconceptions. Alzheimer's & dementia, 19 (5). pp. 2175-2181.

Abstract

Clinical assessments remain the gold standard for diagnosing neurodegenerative dementia and monitoring disease progression and treatment effects as well research. However, rapid soluble biomarker developments hold promise for increasingly targeted therapeutic approaches, targeted selection of participants in clinical trials, and more direct physiological efficacy readouts. Unfortunately, the anchoring of biomarker research to clinical symptomatology and disease progression is often based on brief and uninformative cognitive tests or screening tools that lack sensitivity to the early stages of cognitive decline. The use of these tools has given the impression that cognitive symptoms occur relatively late in the disease and that disease progression in the early stages of disease is slow. This can hinder advancements in the field and may lead to treatment interventions occurring too late. Poor cognitive test selection has likely been a factor in the failure record of dementia drug development over the last two decades.
A thorough cognitive assessment is a powerful tool in the hands of an expert neuropsychologist and continues to play a key role in the accurate and early diagnosis of neurodegenerative disease. This clinical assessment is very different from the cognitive testing we traditionally see in dementia biomarker research and drug development. Yet the distinction between the two approaches is unclear to many. This paper aims to elucidate some of the myths and misconceptions around cognitive research in dementia and suggests a way forward to facilitate biomarker and drug development through the improved utility of cognitive assessment tools.

Item Type:	Article
Keywords:	Clinical endpoints, Biomarkers, cognition, Alzheimer´s disease
Date Deposited:	06 Jun 2023 00:45
Last Modified:	06 Jun 2023 00:45
URI:	https://oak.novartis.com/id/eprint/48487