Accelerated clinical evaluations for Alzheimer's disease: feasibility across specialty and rural care settings
- 1Medical Center University of Kansas Kansas City Kansas USA
- 2School of Medicine and Nursing University of Kansas Salina Kansas USA
- 3Independent Health Care Salina Kansas USA
Abstract
INTRODUCTION: Timely diagnosis of Alzheimer's disease (AD) is increasingly important given the availability of disease‐modifying therapies, yet current diagnostic pathways remain fragmented, resource‐intensive, and difficult to access. We developed the accelerated clinical evaluation for Alzheimer's disease (ACE‐AD), a nursing‐led workflow integrating a clinical interview, cognitive testing, blood biomarkers, and portable magnetic resonance imaging (MRI) to streamline dementia evaluation.
METHODS: ACE‐AD was evaluated in two phases. Phase 1 validated the workflow in 20 participants with standard‐of‐care (SOC) memory clinic diagnoses compared against ACE‐AD‐derived etiologic diagnosis, cognitive staging, and neuroimaging findings. Phase 2 adapted the workflow for a rural neurology practice, assessing feasibility, utility, and acceptability.
RESULTS: In Phase 1 (n = 20), primary etiologic diagnoses were universally concordant between SOC and ACE‐AD evaluations, with 90% agreement on AD as a primary or contributing etiology. Cognitive stage agreed in 13 participants (65%); ACE‐AD rated all discordant cases as less impaired. Portable MRI identified clinically relevant abnormalities consistent with SOC MRI, and patients, care partners, and clinicians rated the workflow highly acceptable. In Phase 2 (n = 7), the rural neurologist reported improved diagnostic confidence, efficiency, treatment planning, and patient communication without workflow disruption.
DISCUSSION: A structured, nursing‐led evaluation integrating blood biomarkers and portable MRI can capture sufficient clinical information to support specialist dementia diagnosis while shifting much of the diagnostic workup earlier in the care pathway. These findings support further evaluation of ACE‐AD as a scalable approach for expanding access to timely dementia diagnosis in both specialty and resource‐limited settings.
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BibTeX
@article{vidoni2026accelerated,
title = {{Accelerated clinical evaluations for Alzheimer's disease: feasibility across specialty and rural care settings}},
author = {Eric D. Vidoni and Jill K. Morris and Karen Weis and Ryan A. Townley and Adam C. Parks and Amanda M. Brunette and Lindsey R. Gillen and Samantha A. Fikru and Alexandria Montero and Rachel Brubaker and Deena Woodall and Sarah Agee and Kyle Summers and Swati Rane Levendovszky and Douglas Davis and Jennifer L. Woodward and Jeffrey M. Burns},
journal = {Alzheimer's \& Dementia},
year = {2026},
month = nov,
doi = {10.1002/alz.71944},
url = {https://doi.org/10.1002/alz.71944},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Accelerated clinical evaluations for Alzheimer's disease: feasibility across specialty and rural care settings
AU - Eric D. Vidoni
AU - Jill K. Morris
AU - Karen Weis
AU - Ryan A. Townley
AU - Adam C. Parks
AU - Amanda M. Brunette
AU - Lindsey R. Gillen
AU - Samantha A. Fikru
AU - Alexandria Montero
AU - Rachel Brubaker
AU - Deena Woodall
AU - Sarah Agee
AU - Kyle Summers
AU - Swati Rane Levendovszky
AU - Douglas Davis
AU - Jennifer L. Woodward
AU - Jeffrey M. Burns
PY - 2026
DA - 2026/11/04
JO - Alzheimer's & Dementia
DO - 10.1002/alz.71944
UR - https://doi.org/10.1002/alz.71944
AB - INTRODUCTION: Timely diagnosis of Alzheimer's disease (AD) is increasingly important given the availability of disease‐modifying therapies, yet current diagnostic pathways remain fragmented, resource‐intensive, and difficult to access. We developed the accelerated clinical evaluation for Alzheimer's disease (ACE‐AD), a nursing‐led workflow integrating a clinical interview, cognitive testing, blood biomarkers, and portable magnetic resonance imaging (MRI) to streamline dementia evaluation. METHODS: ACE‐AD was evaluated in two phases. Phase 1 validated the workflow in 20 participants with standard‐of‐care (SOC) memory clinic diagnoses compared against ACE‐AD‐derived etiologic diagnosis, cognitive staging, and neuroimaging findings. Phase 2 adapted the workflow for a rural neurology practice, assessing feasibility, utility, and acceptability. RESULTS: In Phase 1 (n = 20), primary etiologic diagnoses were universally concordant between SOC and ACE‐AD evaluations, with 90% agreement on AD as a primary or contributing etiology. Cognitive stage agreed in 13 participants (65%); ACE‐AD rated all discordant cases as less impaired. Portable MRI identified clinically relevant abnormalities consistent with SOC MRI, and patients, care partners, and clinicians rated the workflow highly acceptable. In Phase 2 (n = 7), the rural neurologist reported improved diagnostic confidence, efficiency, treatment planning, and patient communication without workflow disruption. DISCUSSION: A structured, nursing‐led evaluation integrating blood biomarkers and portable MRI can capture sufficient clinical information to support specialist dementia diagnosis while shifting much of the diagnostic workup earlier in the care pathway. These findings support further evaluation of ACE‐AD as a scalable approach for expanding access to timely dementia diagnosis in both specialty and resource‐limited settings.
SN - 1552-5260
SN - 1552-5279
ER -