Neurol Ther • https://doi.org/10.1007/s40120-025-00833-8
Expert Guidance on Cognitive Impairment in Alzheimer's Disease: A Practical Seven-Step Approach from the United Arab Emirates
Authors: Tauofik Alsaadi, Abubaker Almadani, Suhail AlRukn, Ali Hassan, Pournamy Sarathchandran, Ahmed Shatila, Miklos Szolics, David Benito, Soydan Ince, Derk W. Krieger
Affiliations: American Center of Psychiatry & Neurology, Rashid Hospital, Sheikh Tahnoon Medical City, Qassimi Hospital, Sheikh Shakhbout Medical City, Eli Lilly, Fakeeh University Hospital, Re:cognition Health
Abstract: Cognitive impairment (CI) spans a spectrum from mild CI to severe dementia, with Alzheimer's disease (AD) the most prevalent cause of CI and dementia. Although dementia burden and prevalence in Arab countries reflect general global trends, the United Arab Emirates (UAE) differs from Western countries both culturally and regarding management resources. Further guidance is therefore needed for the diagnosis and management of CI in the UAE. Methods: A task force of eight neurologists and two non-voting collaborators with special dementia expertise was convened to develop evidence-based position statements/recommendations to guide the diagnosis and management of AD, including the use of amyloid-targeting therapies (ATTs), in the UAE clinical setting. A modified Delphi survey method was chosen to obtain a consensus, ensuring that drafted expert statements reflected diverse perspectives and experiences. Discordance was predefined as>25% of panelists rating an expert statement as≤3 on the Likert scale. Consensus was predefined as a median rating≥7 without discordance. Expert statements achieving consensus were adopted. Results: A seven-step framework for diagnosing and managing CI in the UAE was developed, with consensus achieved on all statements. Recommendations largely aligned with international guidelines on AD dementia management and treatment, combined with UAE-specific guidance. The framework spans the full patient journey from initial symptoms to diagnosis (including biomarker use), initial treatment (including ATTs where appropriate), and subsequent monitoring and management as the disease progresses. Conclusions: Management of CI and dementia in UAE requires consideration of international guidelines in the context of regional and local cultural sensitivities and healthcare resources. A holistic approach is recommended, combining appropriate pharmacological treatment with lifestyle interventions, education, and support for patients and care partners. Patients require ongoing monitoring to ensure the approach is tailored to the disease stage and provides optimal quality of life and reduced burden for patients and care partners.
Keywords: Alzheimer's disease, Amyloid-targeting therapies, Biomarkers, Cognitive impairment, Diagnosis, Guidance, Mild cognitive impairment, United Arab Emirates
Executive Impact
This study introduces the first comprehensive seven-step framework for diagnosing and managing cognitive impairment (CI) and Alzheimer's disease (AD) in the United Arab Emirates (UAE), addressing cultural and resource-specific needs. It provides a holistic approach combining pharmacological treatments with lifestyle interventions, education, and support, crucial for optimizing patient quality of life and reducing caregiver burden. The framework emphasizes early diagnosis and tailored management across disease stages.
0
Key Steps to AD Management
0
Consensus on Core Statements
0
Million affected by Dementia in Arab Countries (2021)
Deep Analysis & Enterprise Applications
Select a topic to dive deeper, then explore the specific findings from the research, rebuilt as interactive, enterprise-focused modules.
Delphi Consensus Approach
96%
Consensus on Core Statements
A modified Delphi survey method was employed, involving 17 experienced UAE-based neurologists and 8 task force members. This rigorous approach ensured that the developed seven expert statements reflected diverse perspectives and experiences, with a consensus achieved on all core statements. Discordance was predefined as >25% rating ≤3 on a Likert scale; consensus as a median rating ≥7 without discordance.
Seven-Step Management Journey
Enterprise Process Flow
When to Suspect CI
→
Clinical Confirmation of CI
→
Confirmation of AD Diagnosis (Biomarkers)
→
Patient & Care Partner Education
→
Lifestyle Changes
→
Current Treatment Options
→
Evaluation & Adjustment
The framework guides the full patient journey from initial symptoms to diagnosis, initial treatment (including amyloid-targeting therapies), and subsequent monitoring and management as the disease progresses. It integrates international guidelines with UAE-specific cultural and resource considerations.
Biomarker Integration for AD Diagnosis
| Biomarker Type | Key Markers & Benefits | Clinical Role in UAE |
|---|---|---|
| CSF Biomarkers |
|
|
| Blood-based (Plasma) Biomarkers |
|
|
| PET Imaging |
|
|
The framework strongly recommends utilizing amyloid PET in the UAE to confirm AD diagnosis and progression for MCI or mild dementia. Alternatively, CSF analysis and fluid biomarker testing (as per 2024 Alzheimer's Association criteria) are also recommended to enhance diagnostic accuracy and differentiate AD from other neurodegenerative conditions.
Holistic Patient-Centered Management
Optimizing Patient Outcomes in UAE
Scenario: A 68-year-old UAE resident presents with subtle memory issues, which his family has noticed becoming more frequent over the past year. He is active in his community, but his children report difficulties with complex tasks like managing finances. Initial screening indicates mild cognitive impairment. Genetic testing reveals APOE ε4 homozygosity, and amyloid PET confirms significant amyloid deposition.
Solution: Based on the UAE framework, the patient undergoes a comprehensive clinical assessment, including a neuropsychological evaluation tailored to his cultural and linguistic background. Biomarker confirmation through amyloid PET and blood-based P-tau217 leads to an early diagnosis of mild AD dementia. He is deemed eligible for an amyloid-targeting therapy (ATT), which is initiated promptly after thorough patient and family education on risks, benefits, and expectations. Concurrently, a multidisciplinary memory service involving neurologists, psychologists, and occupational therapists develops a personalized care plan. This includes cognitive rehabilitation, tailored physical activity, social engagement, and stress management techniques. His family receives extensive education and support, addressing stigma and equipping them to manage evolving needs. Regular follow-up every 3–6 months monitors treatment response, disease progression, and side effects (including ARIA via MRI), with adjustments made as needed to maintain dignity and quality of life.
Outcome: Early and accurate diagnosis, coupled with a holistic, culturally sensitive management plan, allows for the timely initiation of ATTs to slow disease progression. Proactive support for the patient and care partners significantly improves quality of life, reduces caregiver burden, and fosters greater independence. This integrated approach, aligned with the UAE framework, exemplifies optimal AD management, delaying cognitive decline and improving overall well-being.
Calculate Your Potential ROI with Our AI Solutions
See how integrating advanced AI, informed by insights like those above, can transform your enterprise operations and financial performance. Adjust the parameters to fit your organization.
Annual Cost Savings Potential
Annual Hours Reclaimed
Your Path to Advanced AI Implementation
A structured approach ensures seamless integration and maximum impact for your organization.
Phase 1: Discovery & Strategy
Comprehensive analysis of existing workflows, identification of AI opportunities, and development of a tailored implementation strategy.
Phase 2: Pilot Program & Validation
Deploying AI solutions in a controlled environment to validate effectiveness, gather feedback, and demonstrate initial ROI.
Phase 3: Scaled Deployment & Integration
Full-scale integration of AI across relevant departments, ensuring compatibility with existing systems and data infrastructure.
Phase 4: Optimization & Continuous Learning
Ongoing monitoring, performance tuning, and leveraging AI's learning capabilities for continuous improvement and innovation.
Ready to Transform Your Enterprise with AI?
Our experts are ready to discuss how these advanced AI insights can be applied to your specific business challenges. Book a free consultation today.
Ready to Get Started?
Book Your Free Consultation.
Let's Discuss Your AI Strategy!
Lets Discuss Your Needs
Select a Date
Sun
Mon
Tue
Wed
Thu
Fri
Sat