With the landscape of Alzheimer's and dementia research and clinical practice changing rapidly, it is critical that health care professionals stay abreast of the latest in clinical research in prevention, diagnosis, treatment and caregiving. The Alzheimer's Association is leading the development of clinical guidance like appropriate use criteria and, soon, clinical practice guidelines to identify and distill the best-available evidence and draft guidance to support evidence-based decision making in patient care settings. The goal is to provide comprehensive resources and support services for clinical professionals to help them stay on top of the latest scientific breakthroughs in dementia research and disease diagnosis, management, treatment and care.
The clinical practice guideline development process
Evidence-based clinical decision making combines a clinician’s expertise, patients' values and preferences, and the best-available evidence to ensure patient care is as consistent, safe and effective as possible. Clinical practice guidelines distill this evidence and provide scientific support for not only clinical decision making, but shared decision making with patients and systems-level policymaking.
The Alzheimer's Association process for developing guidelines involves evidence synthesis and translation of this evidence into clear, actionable recommendations in close collaboration with a guideline panel of clinical and subject-matter experts, methodologists, external organizations, early career ISTAART volunteers and patient representatives. The Association also provides two opportunities for public comment during the guideline development process; once after the guideline panel drafts the scope of the guideline and once after they formulate recommendations.
The Association utilizes a rigorous and transparent guideline development framework/methodology called GRADE — a widely used approach for rating the quality or certainty of a body of evidence and assigning strength of recommendations — combined with systematic reviews of the best available evidence to inform clinical practice guideline recommendations.
A hybrid methodology will continue to be used for the development of appropriate use criteria and other Association guidance products.
The Alzheimer’s Association is committed to the development of trustworthy clinical practice guidelines and has established rules (PDF) for collecting conflict of interest disclosures from all involved parties. Ultimately, all financial and intellectual disclosures and our methods for managing them will be publicly reported in our published guideline manuscripts.
The Alzheimer's Association will update clinical practice guidelines regularly to ensure they evolve in parallel with advances in science and the needs of clinical practice.
Clinical practice guidelines in progress
Blood biomarkers in specialty care
In collaboration with a comprehensive guideline panel, the Alzheimer's Association will publish its first guideline in spring/summer 2025 on the use of blood tests for Alzheimer's disease diagnosis in patients with cognitive impairment being seen in specialty care settings. Recommendations in the initial iteration of the guideline will answer these clinical questions, among others:
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Can a blood biomarker test be used as a confirmatory test for Alzheimer's in the diagnostic work-up of patients with objective cognitive impairment who present for specialized care related to memory disorders?
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Can a blood biomarker test be used as a triaging test for AD in the diagnostic workup of patients with objective cognitive impairment who present for specialized care related to memory disorders?
The recommendations will be consistently updated to incorporate new science, including additional patient populations and clinical settings. Complementary tools to facilitate clinical decision making and shared decision making with patients, clinical education, and conference presentations will be available in summer 2025.
Other resources and guidance on blood biomarkers
“The Alzheimer's Association appropriate use recommendations for blood biomarkers in Alzheimer's disease” (2022). Alzheimer's & Dementia®: The Journal of the Alzheimer’s Association.
Other upcoming guidelines
The Association is also currently preparing or will soon prepare guidelines on:
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The use of cognitive assessment tools for the detection of MCI and dementia in primary health care settings.
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Staging of Alzheimer's disease.
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Prevention of Alzheimer’s disease and other dementias.
Existing resources for clinical decision making
Clinical practice guidelines versus other types of guidance
Many publications supporting clinical decision making are typically in the format of “guidance” documents (like appropriate use recommendations) that are more broad and primarily utilize expert opinion or interpretation of research findings. Not all recommendations use rigorous systematic evidence collection and analysis to inform recommendations. While important to the research and clinical field, they do not use the same evidence-based framework and methodology as clinical practice guidelines.