New Alzheimer's Definition and the Clinician

The recent publication from the National Institute on Aging and the Alzheimer's Association of a new biomarker-based definition of Alzheimer's disease could cause confusion for clinicians, according to specialists interviewed by MedPage Today . John C. Morris at the Washington University School of Medicine says "in current practice the obtaining and interpretation of Alzheimer biomarkers will be restricted primarily to physicians who specialize in memory disorders." Meanwhile, Johns Hopkins Professor Kostas Lyketsos notes a key issue "is whether payers will reimburse for the biomarker tests proposed since they are costly and not very well standardized." He also says the Centers for Medicare and Medicaid Services are "finishing up a study that will test the utility of biomarker testing. The results will be key. We might find ourselves with this very elegant definition of AD and no way to pay to use it clinically." Mount Sinai Hospital Professor Sam Gandy warns the use of the definition will cause estimates of the prevalence of AD to soar. "I think that the lay public penetration of the notion that there is a 'silver tsunami' that will bankrupt and cause enormous misery to millions of families," he says. "I do not see any upside to driving up the 'scare factor.'"