ABSTRACT
Anti-amyloid treatments for early symptomatic Alzheimer disease have recently become clinically available in some countries, which has greatly increased the need for biomarker confirmation of amyloid pathology. Blood biomarker (BBM) tests for amyloid pathology are more acceptable, accessible and scalable than amyloid PET or cerebrospinal fluid (CSF) tests, but have highly variable levels of performance. The Global CEO Initiative on Alzheimer's Disease convened a BBM Workgroup to consider the minimum acceptable performance of BBM tests for clinical use. Amyloid PET status was identified as the reference standard. For use as a triaging test before subsequent confirmatory tests such as amyloid PET or CSF tests, the BBM Workgroup recommends that a BBM test has a sensitivity of ≥90% with a specificity of ≥85% in primary care and ≥75-85% in secondary care depending on the availability of follow-up testing. For use as a confirmatory test without follow-up tests, a BBM test should have performance equivalent to that of CSF tests - a sensitivity and specificity of ~90%. Importantly, the predictive values of all biomarker tests vary according to the pre-test probability of amyloid pathology and must be interpreted in the complete clinical context. Use of BBM tests that meet these performance standards could enable more people to receive an accurate and timely Alzheimer disease diagnosis and potentially benefit from new treatments.
Subject(s)
Alzheimer Disease , Biomarkers , Humans , Alzheimer Disease/diagnosis , Alzheimer Disease/blood , Alzheimer Disease/cerebrospinal fluid , Biomarkers/blood , Biomarkers/cerebrospinal fluid , Positron-Emission Tomography/standards , Positron-Emission Tomography/methods , Amyloid beta-Peptides/blood , Amyloid beta-Peptides/cerebrospinal fluidSubject(s)
Delirium , Global Health , Public Health , Cognitive Dysfunction/etiology , Delirium/diagnosis , Delirium/therapy , HumansABSTRACT
The US Department of Health and Human Services and the Foundation for the National Institutes of Health, through private sector support, sponsored the National Research Summit on Dementia Care: Building Evidence for Services and Supports (Summit) in 2017. Various workgroups were asked to address topics of interest in dementia care and develop recommendations addressing the goals of the Summit. Workforce education and training was identified to be a key issue. As a result, a Workforce Development Workgroup (the Workgroup) was created and addressed two of the Summit's goals. The first goal is to improve the quality of care and support provided to persons living with dementia and those who care for them. The second goal is to accelerate the development, evaluation, translation, implementation, and scaling-up of evidence-based and evidence-informed services for persons living with dementia, their families, and caregivers. In this article, the Workgroup identified gaps in educating and training a dementia-capable workforce. The Workgroup consisted of an interprofessional team with expertise in dementia workforce development from academia, professional organizations, and the federal government. Four recommendations are presented concerning research topics that will advance the education and training of a dementia-capable workforce, which includes health professions students, faculty, practitioners, direct care workers, persons living with dementia, and those who care for them. J Am Geriatr Soc 68:625-629, 2020.
Subject(s)
Dementia , Staff Development , Teaching/education , Workforce/standards , Caregivers , HumansSubject(s)
Health Personnel , Interprofessional Relations , Aged , Humans , Tumor Suppressor Proteins , WorkforceABSTRACT
This article reviews the background, structure, and role of the Advisory Committee on Interdisciplinary, Community-based Linkages (ACICBL) in the U.S. federal government. The ACICBL's annual reports have consistently addressed interdisciplinary education related to Title VII, Part D-Interdisciplinary, Community-based Linkages programs. The ACICBL is clearly a champion of interdisciplinary/interprofessional education (IPE). ACICBL recommendations since its first report in 2001 have emphasized the need for interdisciplinary/interprofessional initiatives to increase diversity, cultural competence, health disparities, the allied health workforce, the health workforce pipeline, faculty development, rural health workforce, and use of technology for the advancement of interdisciplinary health care. Its most recent report, focusing on the interdisciplinary/IPE of health professions students, faculty, and practitioners, made recommendations around interprofessional faculty development, interprofessional curriculum development, IPE competency development, program evaluation, technology standards, and accreditation standards.
Subject(s)
Advisory Committees/organization & administration , Allied Health Personnel/education , Education, Professional/organization & administration , Interdisciplinary Studies , Cooperative Behavior , Federal Government , Humans , Interprofessional Relations , United StatesABSTRACT
Frail elders living alone or in long-term care settings are particularly vulnerable to bioterrorism and other emergencies due to their complex physical, social and psychological needs. This paper provides an overview of the recent literature on bioterrorism and emergency preparedness in aging (BTEPA); discusses federal initiatives by the health resources and services administration (HRSA) to address BTEPA; describes the collaborative efforts of six HRSA-funded geriatric education centers (GECS) to develop BTEPA geriatric curricula and training; and offers recommendations for BTEPA education and training, clinical practices, policy, and research. The GEC/BTEPA collaboration has produced model curricula, including emergency planning for diverse groups of older persons; enhanced networking among stakeholders in a fast paced environment of information sharing and changing policies; and developed interdisciplinary educational resources and approaches to address emergency preparedness for various settings in the elder care continuum.
Subject(s)
Bioterrorism , Curriculum , Disaster Planning , Frail Elderly , Geriatrics/education , Aged , Aged, 80 and over , Cooperative Behavior , Emergency Medical Services , Frail Elderly/psychology , Humans , Models, Educational , Public Health/education , Quality of Life , United States , United States Health Resources and Services AdministrationABSTRACT
The healthcare workforce is currently unprepared for the increasing number of older persons and the complexities of their healthcare needs. Too few healthcare workers are adequately trained in geriatrics, and developers of educational curricula across healthcare disciplines have been slow to incorporate or require geriatric training. In April 2003, leaders in geriatrics met in Washington, D.C., to discuss and recommend solutions to the growing shortage of an appropriately trained workforce for geriatric research, education, and patient care. After considering data, presenting statistics, and offering insights into the future, the conference concluded by formulating recommendations to meet specific challenges. This report is a summary of the conference proceedings and recommendations, and it serves as a reminder that demographic trends and an everexpanding geriatric knowledge base demand not only attention, but also action.