With the recent news from the lecanemab phase 3 trial suggesting a new treatment for early Alzheimer disease (AD) may be on the way,1 it is more important than ever to ensure that we have accurate methods to identify people who would benefit from pharmaceutical interventions. However, there are many steps on the pathway from promising biomarker to approved screening tool; among these is consideration of population acceptability. With diseases as complex and debilitating as AD and related dementias (ADRDs), and treatments only moderately effective against delaying the symptoms at best, it is important not to assume that people will want to undergo screening tests for ADRDs. In particular, it is crucial that marginalized communities including Indigenous peoples (eg, Māori, Aboriginal Australians, Indigenous Americans) are canvassed to understand whether there are any specific cultural considerations that need to be made to ensure adequate coverage of the population. Without doing so, a biomarker that could potentially reduce health disparities risks instead adding to the inequality among populations.
Barrett-Young A. An Eye on Clinical Translation—Considerations for Research Into Ocular Biomarkers of Alzheimer Disease and Related Dementias. JAMA Ophthalmol. 2023;141(1):91–92. doi:10.1001/jamaophthalmol.2022.4959
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