Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage.
Stephanie J.B. Vos,Frans R.J. Verhey,Lutz Frölich,Johannes Kornhuber,Jens Wiltfang,Wolfgang Maier,Oliver Peters,Eckart Rüther,Flavio Nobili,Silvia Morbelli,Giovanni B. Frisoni,Alexander Drzezga,Mira Didic,Bart N.M. van Berckel,Andrew Simmons,Hilkka Soininen,Iwona Kłoszewska,Patrizia Mecocci,Magda Tsolaki,Bruno Vellas,Simon Lovestone,Cristina Muscio,Sanna-Kaisa Herukka,Eric Salmon,Christine Bastin,Anders Wallin,Arto Nordlund,Alexandre de Mendonça,Dina Silva,Isabel Santana,Raquel Lemos,Sebastiaan Engelborghs,Stefan Van der Mussele,Yvonne Freund-Levi,Åsa K. Wallin,Harald Hampel,Wiesje M. van der Flier,Philip Scheltens,Pieter Jelle Visser,Pieter Jelle Visser +39 more
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The use of the proposed research criteria to identify Alzheimer's disease at the mild cognitive impairment stage and the use of both amyloid and neuronal injury markers as proposed by the National Institute of Ageing-Alzheimer Association criteria offers the most accurate prognosis are supported.Abstract:
Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage according to these criteria. Subjects with mild cognitive impairment (n = 1607), 766 of whom had both amyloid and neuronal injury markers, were recruited from 13 cohorts. We used cognitive test performance and available biomarkers to classify subjects as prodromal Alzheimer's disease according to International Working Group-1 and International Working Group-2 criteria and in the high Alzheimer's disease likelihood group, conflicting biomarker groups (isolated amyloid pathology or suspected non-Alzheimer pathophysiology), and low Alzheimer's disease likelihood group according to the National Institute of Ageing-Alzheimer Association criteria. Outcome measures were the proportion of subjects with Alzheimer's disease at the mild cognitive impairment stage and progression to Alzheimer's disease-type dementia. We performed survival analyses using Cox proportional hazards models. According to the International Working Group-1 criteria, 850 (53%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 50% compared to 21% for subjects without prodromal Alzheimer's disease. According to the International Working Group-2 criteria, 308 (40%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 61% compared to 22% for subjects without prodromal Alzheimer's disease. According to the National Institute of Ageing-Alzheimer Association criteria, 353 (46%) subjects were in the high Alzheimer's disease likelihood group, 49 (6%) in the isolated amyloid pathology group, 220 (29%) in the suspected non-Alzheimer pathophysiology group, and 144 (19%) in the low Alzheimer's disease likelihood group. The 3-year progression rate to Alzheimer's disease-type dementia was 59% in the high Alzheimer's disease likelihood group, 22% in the isolated amyloid pathology group, 24% in the suspected non-Alzheimer pathophysiology group, and 5% in the low Alzheimer's disease likelihood group. Our findings support the use of the proposed research criteria to identify Alzheimer's disease at the mild cognitive impairment stage. In clinical settings, the use of both amyloid and neuronal injury markers as proposed by the National Institute of Ageing-Alzheimer Association criteria offers the most accurate prognosis. For clinical trials, selection of subjects in the National Institute of Ageing-Alzheimer Association high Alzheimer's disease likelihood group or the International Working Group-2 prodromal Alzheimer's disease group could be considered.read more
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NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease
Clifford R. Jack,David A. Bennett,Kaj Blennow,Maria C. Carrillo,Billy Dunn,Samantha Budd Haeberlein,David M. Holtzman,William J. Jagust,Frank Jessen,Jason Karlawish,Enchi Liu,José Luis Molinuevo,Thomas J. Montine,Creighton H. Phelps,Katherine P. Rankin,Christopher C. Rowe,Philip Scheltens,Eric Siemers,Heather M. Snyder,Reisa A. Sperling,Cerise L Elliott,Eliezer Masliah,Laurie M. Ryan,Nina Silverberg +23 more
TL;DR: This research framework seeks to create a common language with which investigators can generate and test hypotheses about the interactions among different pathologic processes (denoted by biomarkers) and cognitive symptoms and envision that defining AD as a biological construct will enable a more accurate characterization and understanding of the sequence of events that lead to cognitive impairment that is associated with AD.
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TL;DR: This work proposes the “A/T/N” system, a descriptive system for categorizing multidomain biomarker findings at the individual person level in a format that is easy to understand and use and suited to population studies of cognitive aging.
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Guy M. McKhann,David A. Drachman,Marshall F. Folstein,Robert Katzman,Donald L. Price,Emanuel M. Stadlan +5 more
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Journal Article
The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease
Guy M. McKhann,David S. Knopman,Howard Chertkow,Bradley T. Hyman,C. R. Jack,Claudia H. Kawas,William E. Klunk,Walter J. Koroshetz,Jennifer J. Manly,Richard Mayeux,Richard C. Mohs,John C. Morris,Martin N. Rossor,Philip Scheltens,Maria C. Carrillo,Bill Thies,Sandra Weintraub,Creighton H. Phelps +17 more
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Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS–ADRDA criteria
Bruno Dubois,Howard Feldman,Claudia Jacova,Steven T. DeKosky,Pascale Barberger-Gateau,Jeffrey L. Cummings,André Delacourte,Douglas Galasko,Serge Gauthier,Gregory A. Jicha,Kenichi Meguro,John T. O'Brien,Florence Pasquier,Philippe Robert,Martin N. Rossor,Steven Salloway,Yaakov Stern,Pieter Jelle Visser,Philip Scheltens +18 more
TL;DR: The NINCDS-ADRDA and DSM-IV-TR criteria for Alzheimer's disease (AD) are the prevailing diagnostic standards in research; however, they have now fallen behind the unprecedented growth of scientific knowledge as discussed by the authors.
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