An Italian tool could change the way medicine approaches Alzheimer's: an algorithm capable of predicting, with remarkable accuracy, which at-risk patients will develop dementia within the next three years. The result comes from Project Interceptor, a national study of our own, the results of which were published in the prestigious scientific journal Alzheimer's & Dementia.
The project was coordinated by Professor Paolo Maria Rossini, director of the Department of Neuroscience and Neurorehabilitation at the IRCCS San Raffaele in Rome, in close collaboration with the Istituto Superiore di Sanità, the Policlinico Gemelli IRCCS, the IRCCS Besta Neurological Institute, the IRCCS San Raffaele in Milan, and the IRCCS Fatebenefratelli in Brescia. The initiative was promoted and funded by the Italian Medicines Agency in conjunction with the Ministry of Health.
Who is the tool aimed at?
The brain normally ages starting in the 50s and 60s, but some people, while not experiencing full-blown dementia, experience what is called mild cognitive impairment (MCI). According to ISS estimates, there are nearly one million such individuals in Italy, and each year, approximately 100.000 of these individuals develop dementia. Projections indicate that up to 50% of people with MCI eventually develop the disease, while the other half tend to remain fully independent. For this reason, identifying those truly at risk in the short term has become a research priority.
How it works
The tool is two-pronged: the basic version—which includes neuropsychological, sociodemographic, and clinical data—achieves a predictive accuracy of at least 72%; adding biomarkers such as volumetric MRI, PET, and genetic testing, the percentage rises to over 82%.
The final result is a predictive nomogram that allows for personalized estimation of the probability of progression to dementia within three years, classifying people with MCI into low, intermediate, or high risk categories. The tool is designed for use not only in research settings, but also in routine clinical practice and public health settings.
Why it is important
This tool allows for risk stratification: if the National Health Service were to implement prevention programs, it could target not the entire million people with mild cognitive decline, but rather, more appropriately and cost-effectively, only the 10.000-20.000 individuals found to be truly high-risk. This approach would also have significant implications for the administration of new anti-amyloid drugs, which are expensive and have significant side effects and cannot be distributed widely without careful patient selection.
The study involved over 350 individuals with MCI, followed for approximately three years in 19 centers throughout Italy. During the observation period, 29,6% of participants developed some form of dementia and 22,4% developed Alzheimer's disease.
This achievement places Italy at the forefront of the early diagnosis of neurodegenerative diseases.
