Neurology 2027

Background: Advances in biomarkers, neuroimaging, and diagnostic criteria have substantially improved the biological identification of Alzheimer's disease. However, the language commonly used to communicate clinical progression remains largely dependent upon broad descriptors such as mild, moderate, and severe, providing limited functional specificity despite increasing diagnostic precision.

Purpose: This presentation examines the disconnect between biological diagnosis and functional characterization in Alzheimer's disease. It proposes that diagnosis, disease stage, and functional presentation represent distinct clinical concepts that should be communicated separately to improve interdisciplinary understanding and individualized care planning.

Framework: The Alzheimer's Tiered Progression Matrix (ProMa™) is introduced as a two-dimensional framework pairing three neurological phases (Neuroamnestic, Neuroadverse, and Neuroabsentia) with three functional tiers (Emerging, Sustained, and Transitional). Rather than replacing existing diagnostic or staging systems, ProMa™ augments them by providing structured language describing how progressive neurological disease is functionally presenting at a given point in time.

A sequential clinical model is proposed in which diagnosis identifies disease, stage describes progression, ProMa™ characterizes functional presentation, assessment identifies support needs, and planning directs individualized action. This distinction creates a clearer pathway for translating advances in neurological science into clinically meaningful communication across disciplines.

As Alzheimer's diagnosis becomes increasingly precise, clinical language must evolve accordingly. More precise functional characterization has the potential to strengthen interdisciplinary communication, improve recognition of longitudinal change, and support the translation of neurological innovation into individualized care.

Lauren P. Brown is an independent Alzheimer's researcher, clinical educator, author, and consultant specializing in Alzheimer's disease characterization and individualized care planning. She is the founder of The Alzheimer's Experience and developer of the Alzheimer's Tiered Progression Matrix (ProMa™), an interdisciplinary framework designed to connect disease biology, functional presentation, and individualized care. Her work focuses on advancing precision language, functional characterization, and clinical communication to improve interdisciplinary understanding and person-centered care. Lauren has presented her research at national and international scientific conferences and is developing a clinical reference framework for Alzheimer's disease from diagnosis through individualized longitudinal care.