ACCESS-AD

Over 50 million people worldwide live with Alzheimer’s disease, and that number is set to rise further as populations age. Caring for people with Alzheimer’s represents a major burden for both families and health and social care systems.

The good news is that there are now treatments (also known as ‘disease-modifying therapies’, or DMTs) that effectively slow the progress of the disease for certain groups of patients, and more are in the pipeline. This marks a paradigm shift in Alzheimer’s care after decades of only limited symptomatic treatment options. In addition, these new therapies also triggered the development of new and better ways to diagnose and monitor the disease.

However, actually getting these new treatments to the right patients at the right time remains a challenge for healthcare systems. Currently, health systems are simply not equipped to manage the growing numbers of Alzheimer’s patients, many of whom wait years just to get a diagnosis. This raises equity concerns, as wealthy patients could skip public sector waiting lists by going private to get faster access to tests and treatments.

The aim of ACCESS-AD – a large, pan-European consortium of public and private partners – is to deliver tools and strategies that will help European healthcare systems to identify solutions that will enhance the care of people living with Alzheimer’s disease, from diagnostic and monitoring tools to lifestyle interventions and new DMTs, and deploy them at the scale needed.

One of the project’s first tasks will be to set up a harmonised data registry to enable the integration and analysis of diverse datasets, as well as the application of artificial intelligence and machine learning for prediction and decision support. This will allow researchers to shed new light on all aspects of Alzheimer’s care, from detection onwards.

Another focus of the project is on opening up access to better tools to diagnose and monitor Alzheimer’s disease. Here the project aims to improve imaging techniques, for example by cutting the scan time for magnetic resonance imaging (MRI) from 20 minutes to just 5. The project will also support the clinical uptake of the ‘Centiloid’ measure of assessing Alzheimer’s disease using PET (positron emission tomography) imaging. In addition, the project plans to make progress on the validation of the ‘Centimarker’ approach to standardising biomarkers in blood and cerebrospinal fluid. Finally, ACCESS-AD will advance the use of digital health tools (such as cognitive testing apps and smartwatches that record both physiological and behavioural data) to monitor patients as they go about their daily lives following diagnosis and/or treatment.

Furthermore, the project will monitor closely the implementation of new DMTs, and explore when and how they can be combined with other interventions such as lifestyle changes and food supplements. The project will also explore mechanistic effects of one of the new drugs in the DMT pipeline, as well as explore how nutrition can help people with dementia and sarcopenia.

The information gathered by the project will help the interdisciplinary teams to provide a wide range of tools and resources, including a better understanding of which patient groups respond well to different DMTs as well as insights into the clinical and economic value of diagnostics and treatment interventions and ethical considerations.

People living with Alzheimer’s disease and their caregivers will play a central role in the project to ensure the outcomes meet their needs. The project has a strong focus on equity; in all its work, it will seek to ensure that as many patients as possible will benefit from its outcomes, including those in underserved (diverse and rural) populations, and those living with more advanced stages of Alzheimer’s.

Ultimately, the project aims for a world where everyone with Alzheimer’s disease can access timely, personalised and cost-effective care, wherever they live and regardless of their socioeconomic status.