AI Insight
This theoretical paper argues that psychological clinical services have not kept pace with recent advances in blood-based biomarkers for early Alzheimer's disease diagnosis. The authors propose a three-phase roadmap for integrating psychological care into AD management: universal prevention through psychoeducation and cognitive reserve promotion, targeted interventions for at-risk individuals with positive biomarkers including neuropsychological evaluation and early cognitive intervention, and support for those with established AD through cognitive rehabilitation and caregiver assistance. The framework aligns with the International Working Group's definition of AD as a clinical-biological entity and emphasizes treating biomarker-positive cognitively normal individuals as at-risk rather than diagnosed.
Why it matters
As blood-based biomarkers enable earlier detection of Alzheimer's risk, psychological services need systemic integration into dementia care pathways. The proposed roadmap provides a practical framework for policymakers to incorporate psychologists into multidisciplinary teams and for updating professional training programs to address prevention and early intervention, potentially improving outcomes for at-risk populations and caregivers.
Understand the Science
Recent advances in blood-based biomarkers have transformed the early diagnosis of Alzheimer’s disease (AD), enabling the identification of biological risk at preclinical and presymptomatic stages in a noninvasive and accessible manner. Despite this diagnostic progress, the expansion of psychological clinical services in dementia care has not kept pace, representing a critical gap in the current management of AD. This theoretical paper critically discusses the role of psychological clinical practice in the prevention and management of AD in light of these diagnostic advances, particularly from the perspective of the International Working Group (IWG), which defines AD as a clinical-biological entity and recommends that cognitively normal individuals with positive biomarkers be considered at risk rather than diagnosed. Based on this framework and on evidence from the 2024 Lancet Commission on dementia prevention, we propose a three-phase roadmap for the integration of psychological care into multidisciplinary AD management. Phase 1 encompasses universal prevention through psychoeducation, cognitive reserve promotion, and emotional education. Phase 2 targets at-risk individuals with elevated biomarker profiles, focusing on neuropsychological evaluation, risk disclosure support, and early cognitive intervention. Phase 3 addresses individuals with established AD through cognitive rehabilitation and caregiver support. We further argue that government policies must integrate psychologists into multidisciplinary neurological and geriatric teams, and that psychology training programs must be updated to prepare professionals for preventive roles. More research on standardized psychological protocols for pre-dementia contexts is urgently needed.
Source: New Alzheimer’s disease diagnostics and psychological clinical perspectives