Browsing by Author "Kandiah N."

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    A Framework for Best Practices and Readiness in the Advent of Anti-Amyloid Therapy for Early Alzheimer’s Disease in Asia
    (2024-08-27) Lee J.H.; Jia J.; Ji Y.; Kandiah N.; Kim S.Y.; Mok V.; Pai M.C.; Senanarong V.; Suh C.H.; Chen C.; Lee J.H.; Mahidol University
    Advances in biomarker-based diagnostic modalities, recent approval of anti-amyloid monoclonal antibodies for early Alzheimer’s disease (AD; mild cognitive impairment or mild dementia due to AD) and late-stage clinical development of other disease-modifying therapies for AD necessitate a significant paradigm shift in the early detection, diagnosis and management of AD. Anti-amyloid monoclonal antibodies target the underlying pathophysiological mechanisms of AD and have demonstrated a significant reduction in the rate of clinical decline in cognitive and functional outcome measures in patients with early AD. With growing recognition of the benefit of early interventions in AD, an increasing number of people may seek diagnosis for their subjective cognitive problems in an already busy medical system. Various factors such as limited examination time, lack of expertise for cognitive assessment and limited access to specialized tests can impact diagnostic accuracy and timely detection of AD. To overcome these challenges, a new model of care will be required. In this paper, we provide practical guidance for institutional readiness for anti-amyloid therapies for early AD in Asia, in terms of best practices for identifying eligible patients and diagnosing them appropriately, safe administration of anti-amyloid monoclonal antibodies and monitoring of treatment, managing potential adverse events such as infusion reactions and amyloid-related imaging abnormalities, and cross-disciplinary collaboration. Education and training will be the cornerstone for the establishment of new pathways of care for the identification of patients with early AD and delivery of anti-amyloid therapies in a safe and efficient manner to eligible patients.
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    Current status and future directions for the diagnosis and management of mild cognitive impairment in Southeast Asia: A SEACURE consensus paper
    (2025-05-01) Bhalla G.; Tanoto P.; Vipin A.; Chen X.Y.J.; Leow Y.J.; Chen C.; Yap P.L.K.; Merchant R.A.; Hilal S.; Ong A.P.; Ampil E.R.; Idris M.I.; Looi I.; Dominguez J.; Yusoff S.; Tan M.P.; Tran C.T.; Tong M.T.; Senanarong V.; Turana Y.; Kandiah N.; Bhalla G.; Mahidol University
    Global aging populations are facing increased prevalence of mild cognitive impairment (MCI) - the preclinical stage of dementia characterized by single/multi-domain neurocognitive decline that does not impair an individual's normal daily functioning. Asian populations are at increased risk of developing MCI and dementia, and many cases go undetected in Southeast Asia (SEA), resulting in increased burden on patients, caregivers and national healthcare systems. There is an urgent need for efficient and scalable diagnostic and management strategies across SEA. Our findings illustrate that current strategies are limited by insufficient resources and a lack of awareness, particularly in developing SEA nations. Strategies for improving the MCI landscape in SEA include increasing widespread community awareness and cognitive health screenings for individuals with a history of vascular risk factors, validation of traditional cognitive screening tests in the respective countries, greater access to blood-biomarker testing, and the development and validation of novel digitized diagnostics.
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    Modernizing diagnosis of Alzheimer's disease: A review of global trends and Asia-specific perspectives
    (2025-08-01) Iwatsubo T.; Sperling R.A.; Algeciras-Schimnich A.; Arai H.; Barron A.M.; Benzinger T.L.S.; Carrillo M.C.; Chen C.; Choi S.H.; Fontana I.C.; Graff-Radford J.; Grill J.D.; Heidebrink J.; Hu C.J.; Ihara R.; Ikeuchi T.; Iwata A.; Ip F.C.F.; Fitri F.I.; Jack C.R.; Jeong J.H.; Jia J.; Kandiah N.; Kim S.Y.; Kowa H.; La Joie R.; Niimi Y.; Noritake R.; Okonkwo O.C.; Palmqvist S.; Rafii M.S.; Raman R.; Shen Y.; Simuni T.; Snyder H.M.; Sriwannopas O.; Stoeckel L.E.; van der Flier W.M.; Wang H.; Wilcock D.M.; Zetterberg H.; Zhou J.; Mahinrad S.; Sexton C.E.; Iwatsubo T.; Mahidol University
    The landscape of Alzheimer's disease (AD) and related dementias (ADRD) diagnosis is evolving rapidly, driven by advances in disease understanding, biomarker tools, and disease-modifying therapies. Modern diagnostic approaches emphasize biological precision, early detection, and dynamic frameworks that adapt to treatment-induced changes in disease biology. These frameworks enable opportunities for personalized interventions—encompassing pharmacological and non-pharmacological strategies—and for enhanced clinical trial design. However, implementing these advancements globally is influenced by diverse cultural, infrastructural, and regulatory factors. The 2024 Alzheimer's Association International Conference Advancements: Modernizing Diagnosis, held in Japan, provided a unique platform to explore these global dynamics, particularly from an Asian perspective. This article highlights key discussions from the conference, exploring the role of biomarker-based diagnostic frameworks in shaping the future of AD/ADRD research, diagnosis, and treatment. We highlight regional challenges and successes and emphasize ethical considerations and practical strategies needed to ensure equitable access to diagnostic and therapeutic innovations. Highlights: Advances in biomarkers are reshaping Alzheimer's disease diagnosis and treatment. Modern diagnostic frameworks highlight biological precision, early detection, and dynamic frameworks. The 2024 Alzheimer's Association International Conference Advancements: Modernizing Diagnosis explored challenges and opportunities in global biomarker implementation. The conference explored geographic-specific impacts, focusing on Asia.