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Clinical Digest: November Update

Dear ISTAART Member,

Welcome to the November ISTAART Clinical Digest. This edition highlights clinician-focused convenings, including the upcoming ALZ-NET Regional Meeting in Florida and the Clinical Trials on Alzheimer's Disease (CTAD) meeting in San Diego. Also learn about updates to ALZPro, our virtual repository of evidence-based tools to support clinicians, and the latest clinician-focused science in our journal family. As part of ISTAART, you have direct access to tools and a community committed to improving dementia care together. Read on to explore this month's updates.

Announcements, Events and Opportunities

ALZ-NET Regional Meeting | Dec. 12 in Tampa and Online
Free for ALZ-NET sites | Virtual access free for ISTAART members
Connect with peers across the ALZ-NET community for a day focused on collaboration, insights and advancing Alzheimer's treatment and care. The ALZ-NET Regional Meeting: Connecting the Clinical Community in the Southeast brings together clinicians, researchers and site staff to share best practices and strengthen the network driving innovation in treatment and diagnostics.

Why attend:

Learn from peers: Hear real-world perspectives from active ALZ-NET sites on operations, patient enrollment and data collection.
Stay current: Gain insights into emerging therapies, imaging and biomarker advances shaping clinical practice.
View the agenda. Collaborate directly: Connect with the ALZ-NET operations team and colleagues from other sites.
Earn CME credit: Participation includes CME opportunities.

Registration is free for ALZ-NET sites, and virtual attendance is complimentary for ISTAART members. Discounted in-person rates are also available for ISTAART members. Register today.

Join us at CTAD 2025! | December 1-4, 2025
The Alzheimer's Association will be sharing groundbreaking research and real-world data at this year's Clinical Trials on Alzheimer's Disease (CTAD) conference, both in San Diego and online.

Symposium: The U.S. POINTER Trial: Imaging, neurovascular, and sleep outcomes
Dec. 2 at 11 a.m.
Discover the impact of lifestyle interventions on imaging, neurovascular health, and sleep through the POINTER trial's ancillary studies.
Poster: Baseline Gut Microbiome Composition Informs About Cognitive Changes in Lifestyle and Diet Interventions in Older Adults: Results from the U.S. POINTER-Microbiome Study
P222 | Presenter: Lucas Patel
Symposium: ALZ-NET: First Look at Real-World Use of Novel Alzheimer's Disease Therapies in the United States
Dec. 3 at 1:30 p.m.
Hear the first-ever insights from the U.S. registry on the real-world use of FDA-approved therapies for Alzheimer's disease.
Poster: Baseline Characteristics and Preliminary Safety from a Multicenter, Safety Surveillance Study of Lecanemab Treatment for Alzheimer's Disease in Real-World Clinical Practice using Alzheimer's Network for Treatment and Diagnostics (ALZ-NET) Registry
P055 | Presenter: Marwan Sabbagh

Clinical Practice Guidelines: Advancing Early Detection and Diagnosis
The Association's Blood-Based Biomarker Guideline for Specialty Care outlines how and when clinicians can responsibly integrate blood tests into diagnostic evaluation for Alzheimer's and other dementias.

Coming in early 2026, a guideline on the use of cognitive assessments in primary care will expand this work by standardizing screening and diagnostic approaches across care settings—advancing timely, person-centered detection and diagnosis.

Have You Met Your CE Requirement for the Year?
As the year winds down, it's the perfect time to check your continuing education progress. As an ISTAART member, you have access to free and discounted accredited courses to help you stay current on the latest in dementia science and care, from diagnosis and treatment to person-centered approaches.

Explore the full clinical education catalog at training.alz.org.

ALZPro: A Clinician's Toolbox for Dementia Care
ALZPro brings together practical, evidence-based tools to support clinicians in delivering person-centered dementia care. Explore featured resources designed to enhance everyday practice, like:

Get to Know Me Form: A practical tool to help care professionals understand the complete person — their values, beliefs, interests, and abilities — to inform every interaction and experience.
Checklist for PCPs: Diagnostic Evaluation, Testing, Counseling and Disclosure of Suspected Alzheimer's Disease: A practical checklist to help primary care providers identify and manage cognitive impairment.
Discussing Anti-Amyloid Treatments with Patients: Tips and strategies to help clinicians have informed, person-centered conversations about anti-amyloid therapies.

Explore these and more at Explore these resources and more on ALZPro.

Funding Updates

Bridge Funding for Disrupted Neurodegenerative Research
The Alzheimer's Association and The Michael J. Fox Foundation, along with support from the Robertson Foundation and other partners, have launched a new program to provide short-term bridge funding (3–12 months) for early-career researchers whose Alzheimer's, Parkinson's, and related neurodegenerative research has been disrupted by shifts in federal priorities. Letters of Intent are now open. Learn more.

For more information about the Alzheimer's Association grant programs, visit alz.org/grants or you can contact a member of the Alzheimer's Association Grants staff at grantsapp@alz.org.

Journal Spotlight

Alzheimer's & Dementia^®: The Journal of the Alzheimer's Association
Alzheimer's Association Clinical Practice Guideline on the use of blood-based biomarkers in the diagnostic workup of suspected Alzheimer's disease within specialized care settings
Palmquisti et al. summarized new Clinical Practice Guidelines developed by an Alzheimer's Association convened expert panel on the use of blood-based biomarkers (BBMs) in the diagnostic evaluation of suspected Alzheimer's disease (AD). Using a systematic review and the GRADE framework, the panel assessed the diagnostic accuracy of plasma p-tau (p-tau217, %p-tau217, p-tau181, and p-tau231) as well as amyloid-β42/40 ratio. These markers were compared against reference standards including CSF biomarkers, amyloid PET, and neuropathological grading. Recommendations indicate that BBMs demonstrating ≥90% sensitivity and ≥75% specificity may be used as triaging tools, while those achieving ≥90% sensitivity as well as specificity may substitute for amyloid PET or CSF in specialized memory care settings. Importantly, the convened panel cautioned many commercially available assays do not yet meet these performance thresholds and that BBMs should complement, not replace, comprehensive clinical evaluation and be interpreted with consideration of AD pretest probability. By providing performance-based, brand-agnostic recommendations and linking them to living evidence updates, the guideline offers a rigorous and adaptable framework for clinical practice. This work highlights both the current utility and the evolving promise of BBMs in improving diagnostic pathways for AD within specialized care.
DOI: 10.1002/alz.70535

Alzheimer's & Dementia: Behavior & Socioeconomics of Aging (BSEA)
Associations of place-based social determinants of health with biomarkers of Alzheimer's disease and related dementias
Krishnamurthy et al. detailed findings from a new study of how place-based social determinants of health (SDoH) relate to Alzheimer's disease and related dementias (ADRD) biomarkers. Associations between several key markers of SDoH, Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Environmental Justice Index (EJI), and both neuroimaging and plasma-based biomarkers were compared in 679 individuals within the Healthy Brain Study. Neuroimaging markers included cortical thickness, brain parenchymal volume, white matter hyperintensity volume, and cerebral blood flow. Plasma markers included glial fibrillary acidic protein (GFAP), amyloid-beta ratios, and phosphorylated tau-181. Results demonstrated place-based associations of SDoH burden were higher among Black participants compared to White participants. Specifically, within Black participants, relationships existed between 1) higher Social Vulnerability Index and greater cerebral blood flow variability, 2) higher Area Deprivation Index and lower cerebral blood flow, and 3) higher Social Vulnerability Index and lower cortical thickness. These patterns, including several involving novel SDoH markers like Social Vulnerability Index and Environmental Justice Index, highlight the potential adverse effects of place-based SDoH on brain health. As findings may reflect the cumulative impact of structural racism, the authors call for policy-focused, community-level interventions to mitigate disparities in cognitive aging and dementia risk.
DOI: 10.1002/bsa3.70030

Alzheimer's & Dementia: Diagnosis, Assessment, & Disease Monitoring (DADM)
Blood biomarkers for Alzheimer's disease: Reliable change and impacts of renal and blood–brain barrier function
Behrens et al. investigated biological and physiological factors influencing blood-based biomarkers for Alzheimer's disease (AD). The goal of the study was to improve diagnostic accessibility of blood-based biomarkers and help increase accurate clinical interpretations. Biomarkers of serum phosphorylated tau-181 (s-p-tau181), plasma amyloid beta (Aβ) 42/40 ratio, as well as phosphorylated Aβ ratio (p-Aβ42/Aβ40) were explored for variability and susceptibility to biological influences. In this study, 57 adults undergoing cognitive evaluation and lumbar puncture at a memory clinic provided repeated blood samples to assess test–retest reliability and the impact of renal and blood–brain barrier (BBB) function. Study results yielded substantial variability in s-p-tau181 measurements, while p-Aβ42/Aβ40 demonstrated greater stability. Importantly, renal function and BBB integrity significantly affected s-p-tau181 levels, but p-Aβ42/Aβ40 remained unaffected by these physiological factors. The findings from this study highlight the need for caution when interpreting longitudinal changes in s-p-tau181 and identify biomarker variability may reflect biological influences rather than disease progression. Evaluation of renal and BBB integrity provides a novel avenue of interpreting test-retest variability and emphasizes the importance of considering physiological function when implementing blood-based biomarkers in clinical diagnostics and monitoring for AD.
DOI: 10.1002/dad2.70181

Alzheimer's & Dementia: Translational Research & Clinical Interventions (TRCI)
Characterizing clinician communication with patients about lecanemab: A qualitative study of clinicians across seven academic medical centers
Parks et al. highlight results from a qualitative study examining how clinicians communicate the benefits and risks of anti-amyloid monoclonal antibody (mAb) treatments for Alzheimer's disease. These therapies modestly slow cognitive decline but carry risks of amyloid-related imaging abnormalities (ARIA), which can be serious or fatal. The goal of this study was to determine similarities and differences in physician-led conversations around anti-amyloid mAb treatments. Semi-structured interviews were conducted with 27 clinicians, primarily neurologists, across seven academic medical centers, and analyzed using a hybrid inductive–deductive thematic approach. There were three major themes that emerged. First, clinicians differed in their communication strategies, such as the use of analogies, statistical framing, and the emphasis placed on risks versus benefits. Second, patient-specific factors, such as comorbidities, emotional outlook, and caregiver involvement, shaped how conversations were individually tailored. Third, clinicians' approaches reflected variations in professional training, personal communication style, and individual perspectives toward the therapy. While clinicians respected patient autonomy, many stopped short of directly recommending treatment and occasionally advised against it. Overall, the study highlights considerable diversity in how clinicians discuss anti-amyloid mAb therapies and underscores the need for structured communication frameworks to support shared decision making. This study provides insight into the need for future alignment of treatment discussions with patient values and preferences at the forefront.
DOI: 10.1002/trc2.70150

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Disclaimer: This newsletter is for informational purposes and is not intended to provide medical advice. This communication is intended for clinicians specializing in dementia. If you received this message in error or would prefer not to receive further updates, please contact ISTAART.

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