{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:36:21Z","timestamp":1773934581008,"version":"3.50.1"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer's Disease Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The limited efficacy of current symptomatic treatments for Alzheimer's disease (AD) leads many patients to forgo medical help. However, new disease-modifying treatments (DMTs), such as donanemab and lecanemab, show potential to change this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To model the impact of these treatments on Slovenia's healthcare system by analyzing patient flow under both current and enhanced capacities, assuming DMT availability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study estimates 76,923 potential DMT candidates aged 65 years and older with mild cognitive impairment or mild AD. Using data from Slovenia's three specialized centers for cognitive disorders, a Markov model simulated five five-year scenarios: baseline, real-life, real-life with capacity enhancement, biomarker integration, and biomarker integration with capacity enhancement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Waiting times for specialist evaluation would increase from the current 3\u201312 months to 1.8 years. The primary bottleneck is lumbar puncture with cerebrospinal fluid (CSF) analysis, during which 64% of patients would become ineligible for DMT. The shortest waiting time to receive DMT occurs in the biomarker integration with capacity enhancement scenario, at 4 years, reducing ineligibility to 7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Current specialized outpatient facilities are limited, causing significant bottlenecks, especially in CSF analysis. Severe waiting times under current capacities mean many patients would progress to moderate or severe dementia or die before receiving treatment. Plasma biomarkers offer a promising triage approach to guide patients toward lumbar puncture or other confirmatory diagnostics, potentially easing this critical bottleneck. Substantial infrastructure and workforce improvements are essential to ensure timely and equitable access to DMTs in Slovenia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25424823261424524","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:23:01Z","timestamp":1773926581000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimates of current capacity for diagnosing and implementation of new treatment Alzheimer's disease in Slovenia"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1430-9933","authenticated-orcid":false,"given":"Eva","family":"Zupanic","sequence":"first","affiliation":[{"name":"University Medical Centre Ljubljana"},{"name":"University of Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ga\u0161per","family":"Stegnar","sequence":"additional","affiliation":[{"name":"Jo\u017eef Stefan Institute"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Raku\u0161a","sequence":"additional","affiliation":[{"name":"Centre for Clinical Psychiatry, University Medical Centre Maribor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Polona","family":"Rus Prelog","sequence":"additional","affiliation":[{"name":"University of Ljubljana"},{"name":"University Psychiatric Clinic Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"\u0160vab","sequence":"additional","affiliation":[{"name":"University of Ljubljana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milica","family":"Gregoric Kramberger","sequence":"additional","affiliation":[{"name":"University Medical Centre Ljubljana"},{"name":"University of Ljubljana"},{"name":"Department of Neurobiology, Care Sciences and Society"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"World Alzheimer report 2015. The global impact of dementia: an analysis of prevalence, incidence, cost and trends","author":"Prince M","year":"2015","unstructured":"Prince M, Wimo A, Guerchet M, et al. World Alzheimer report 2015. The global impact of dementia: an analysis of prevalence, incidence, cost and trends. London: Alzheimer's Disease International, 2015."},{"key":"e_1_3_3_3_2","unstructured":"US Food and Drug Administration (FDA). FDA converts novel Alzheimer\u2019s disease treatment to traditional approval [online] https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-converts-novel-alzheimers-disease-treatment-traditional-approval (accessed 13 July 2024)."},{"key":"e_1_3_3_4_2","unstructured":"US Food and Drug Administration (FDA). FDA approves treatment for adults with Alzheimer\u2019s disease [online] https:\/\/www.fda.gov\/drugs\/news-events-human-drugs\/fda-approves-treatment-adults-alzheimers-disease (accessed 13 August 2024)."},{"key":"e_1_3_3_5_2","unstructured":"European Medicines Agency (EMA). Leqembi [online] https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/leqembi (accessed 13 December 2024)."},{"key":"e_1_3_3_6_2","unstructured":"Lilly. Lilly's Kisunla (donanemab) receives marketing authorization by European Commission for the treatment of early symptomatic Alzheimer's disease [online] https:\/\/investor.lilly.com\/news-releases\/news-release-details\/lillys-kisunla-donanemab-receives-marketing-authorization-0 (accessed 12 October 2025)."},{"key":"e_1_3_3_7_2","first-page":"2","article-title":"Assessing the preparedness of the health care system infrastructure in six European countries for an Alzheimer's treatment","volume":"8","author":"Hlavka JP","year":"2019","unstructured":"Hlavka JP, Mattke S, Liu JL. Assessing the preparedness of the health care system infrastructure in six European countries for an Alzheimer's treatment. Rand Health Q 2019; 8: 2.","journal-title":"Rand Health Q"},{"key":"e_1_3_3_8_2","unstructured":"Lin G D Whittington M Wright A et al. Antibodies for early Alzheimer\u2019s disease: effectiveness and value; evidence report. 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Prebivalstvo po spolu in po starosti ob\u010dine in naselja Slovenija letno [online] https:\/\/pxweb.stat.si\/SiStatData\/pxweb\/sl\/Data\/-\/05C5003S.px\/ (accessed 12 November 2023)."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000108099"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000499763"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12694"},{"key":"e_1_3_3_14_2","unstructured":"Alzheimer Europe. Prevalence of dementia in Europe. 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