Abstract Body

The ATN framework clearly paves the way for a diagnosis before the stage of AD-dementia. In clinical practice, a diagnosis in predementia stages in fact entails a prognosis, as patients want to know what they can expect. Using ATN biomarkers, individualized risk profiling for MCI patients becomes feasible. A clinical encounter study evaluating doctor-patient communication in memory clinics revealed however that clinicians are quite reluctant to share specific prognostic information with MCI patients. In the context of predementia diagnosis, Subjective Cognitive Decline (SCD) is even more challenging. A recent point of view paper provides a clinical characterization of SCD, and attempts to provide directions for clinicians. Although on a group level, ATN biomarkers clearly predict incident dementia in SCD, individualized risk modeling remains challenging, as current models have suboptimal generalizability, due to the lack of truly longitudinal data.Yet, the number of people wanting to know the status of their brain health with the ambition to maintain or improve their own brain health rapidly increases. In a Delphi study to identify topics most relevant to discuss in the diagnostic process, patients and caregivers indicated they value precise and specific information, even when that does not provide complete certainty.Tools to support both clinicians and patients/families in decision making and communicating about AD diagnosis are therefore urgently needed. ADappt (www.adappt.health) is a first attempt at providing such a tool.