By: Hayley So, Vivek Kommi, Naina Kumar, Beatrice Milasan, Areen Charania

<aside> 💡 Problem Statement: Over 6.7 million Americans age 65 and older are living with Alzheimer's in 2023. By 2050, the number of people aged 65 and older with Alzheimer’s may grow to a projected 12.7 million.

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Alzheimer's disease (AD) is the 6th leading cause of death in the U.S. ****Alzheimer's research holds immense potential for improving lives, but the diagnostic process is far from ideal. It's costly, invasive, inaccessible, and often delayed until symptoms appear, despite the disease starting much earlier.

In 2020, the direct cost to American society of caring for those with AD was an estimated $305 billion of which Medicare/Medicaid pays 67%—that’s $45,522 per patient annually. By 2050, this cost is expected to increase to USD 1.1 trillion.

Additionally, it can take 20 years to recognize subtle cognitive changes or impairments and diagnose pre-clinical AD.

Pre-clinical Alzheimer’s refers to the stage in which early brain changes are present but cognitive symptoms have not yet appeared. A shocking 30% of adults aged 65+ have pre-clinical AD.

Current diagnostic tests for Alzheimer's disease include blood and urine testing, psychiatric and neurological evaluations, brain imaging (MRI, CT, or PET scan), and a lumbar puncture. However, these tests can be expensive and invasive, with brain scans requiring annual repetition to confirm Alzheimer’s disease.

To prevent the cascade of negative effects that often accompany AD in its late stages (i.e. escalating medical bills, troubling interpersonal behavior anxiety over the future, and overall low quality of life), we need new ways to diagnose individuals at an earlier stage.

• Why are current diagnoses of AD invasive?
• How much do tests for AD cost? (USD)
• What is the issue with current biomarkers?

Alzheimer’s patients are not diagnosed early enough

Why is this happening?

1. No routine-monitoring
   • Dementia diagnosis often starts with clinician suspicion based on symptoms or caregiver concerns in primary care.
   • Diagnosing dementia in older adults (OAs) in primary care is challenging due to brief provider-patient interactions and the complexity of multiple symptoms.
   • Early dementia symptoms, like memory impairment, may not be evident in routine visits unless specifically assessed.
2. Fear of emotional distress
   • Only 45% of people with Alzheimer's disease or their caregivers/general practitioners are told their diagnosis by their doctor.
   • Doctors are afraid to tell patients they have AD because of the emotional distress that it might cause.
3. Symptoms in pre-clinical AD in patients are extremely subtle
   • Also called “non-Alzheimer dementia” as there are no extreme symptoms. Thus, creating less incentive for patients to seek treatment.

Early diagnosis of AD is important as symptoms as it can potentially slow the progression using early interventions. As well, helping affected individuals and families prepare for this shift emotionally and financially.

Driving behavior in older adults x predicting pre-clinical AD

Study #1: Improved Alzheimer's prediction with GPS data

• Researchers from the University of Toronto achieved an 86% accuracy in forecasting pre-clinical Alzheimer's using GPS driving data and age, surpassing the 82% accuracy of FDG-PET Scans.