AD-RIDDLE: Real-World Implementation, Deployment And Validation Of Early Detection Tools And Lifestyle Enhancement

阿尔茨海默病（AD）是痴呆症的主要原因，是我们这个时代的主要全球健康挑战之一。这种致残性疾病影响着全世界5500万人，成本超过1.3万亿美元。仅在欧洲就有6700万人面临AD痴呆（前驱和临床前AD）的风险，这是一个主要的未满足的公共卫生需求，给欧洲经济、医疗保健和社会保健系统带来了越来越大的负担，也是对未来的担忧。然而，一直缺乏预防和早期发现战略。疾病修饰疗法的最新进展以及基于可改变的生活方式和血管因素（预防潜力约40%）的预防性多领域干预的巨大潜在益处提供了新的机会。基于血液的生物标志物（BBM）和数字认知测试的新发展使更广泛，更具成本效益的测试成为可能。AD-RIDDLE平台旨在彻底改变AD在医疗保健环境（HCS）中的检测、诊断、预防和治疗方式。AD-RIDDLE以工具箱平台概念为中心，在每个关键步骤提供一系列经过验证的工具，使HCS和从业人员能够在不同的患者人群中部署增强的AD管理。AD-RIDDLE工具箱平台将包括a）社区外展工具，以提高对AD预防的认识/激活; B）易于获得的、临床验证的生物标志物的组合：数字认知工具和BBM，用于早期检测AD痴呆风险; c）经验证的算法，支持临床决策，以使用精确预防方法识别可以从特定预防性治疗（药物和/或非药物）中受益的人群。工具箱的可用性和有效性将在现实世界中进行测试。我们希望AD-RIDDLE模块化和灵活的设计可以促进不同医疗保健系统的广泛采用，其工具可以推进研究，以开发具有成本效益的AD预防性疗法，并可扩展用于其他痴呆症

Alzheimer's disease (AD), the main cause of dementia, is one of the major global health challenges of our time. This disabling disorder affects 55 million people worldwide, with costs above $1.3 trillion. With 67 million people at risk for AD dementia (prodromal and preclinical AD) in Europe alone, it is a major unmet public health need, with increasing burden for European economies, healthcare and social care systems and a concern for the future. Yet, prevention and early detection strategies have been lacking. Recent advances in disease-modifying therapies and the huge potential benefits of preventive multidomain interventions based on modifiable lifestyle and vascular factors (prevention potential ~ 40%) provide new opportunities. New developments in blood-based biomarkers (BBMs) and digital cognitive tests enable broader, cost-effective testing. The AD-RIDDLE platform is envisioned to revolutionize how AD is detected and diagnosed, prevented and treated across healthcare settings (HCS). AD-RIDDLE centres around a toolbox platform concept, providing a series of validated tools at each key step to enable HCS and practitioners to deploy enhanced AD management across diverse patient populations. The AD-RIDDLE toolbox platform will include a) community outreach tools to increase awareness/activation on AD prevention; b) combination of easily available, clinically validated biomarkers: digital cognitive tools and BBMs, for early detection of AD dementia risk; c) validated algorithms supporting clinical decisions, to identify people who can benefit from specific preventive therapies (pharma and/or non-pharma) using precision prevention approach. The toolbox usability and efficacy with be tested in realworld settings. We expect that the AD-RIDDLE modular and flexible design can facilitate broad uptake from different healthcare systems, and its tools can advance research to develop cost-effective preventive therapies for AD, with scalability for other dementias