March 11, 2019 | JAMA Neurology

"Preclinical Alzheimer Disease and the Dawn of the Pre-Caregiver" by Emily Largent and Jason Karlawish

Two lines of innovation—one legal and one scientific—will soon converge to change the lived experience of AD for patients and their families. Federal and state laws are improving clinical care for AD by promoting care planning and care partner engagement. At the same time, our understanding of AD as a clinicopathologic state, defined by observable signs and symptoms, is evolving toward a biomarker-based understanding. As a result, AD diagnosis will soon occur in a preclinical stage before the onset of symptoms, family members will be engaged much earlier in the course of disease, and conversations like the one described above will become increasingly frequent.

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