POCNAlzheimer’s Disease: What NPs and PAs Should Know Now

⚠️ Early Stage Research
This 2024 review consolidates AD pathophysiology, risk stratification, diagnostic modalities, and treatment progress for NP/PA practice. Peripheral biomarkers and tau-targeting strategies remain research-stage; the review reports no new approvals or guideline changes.

Clinical Considerations

• APOE4 carrier status elevates AD risk substantially and should inform early cognitive screening conversations with at-risk patients.
• Vascular and metabolic comorbidities including hypertension, diabetes, and obesity are modifiable contributors to AD risk and progression.
• Amyloid-targeting therapies lecanemab and donanemab are FDA-approved for early-stage AD; appropriate patient selection and ARIA monitoring are required.
• Peripheral blood biomarkers show early diagnostic promise in high-risk populations but lack validation for routine clinical use.

Practice Applications

• Integrate APOE risk discussion into cognitive screening for patients with family history of early-onset AD.
• Monitor vascular risk factors aggressively; hypertension and diabetes control directly influences AD progression trajectory.
• Recognize eligibility criteria for lecanemab and donanemab before initiating specialist referral conversations.
• Avoid presenting peripheral biomarker testing as clinically available; current evidence is research-stage only.

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