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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Alzheimers+Dis
2018 ; 62
(3
): 1067-1077
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The Rationale Behind the New Alzheimer s Disease Conceptualization: Lessons
Learned During the Last Decades
#MMPMID29562531
Molinuevo JL
; Minguillon C
; Rami L
; Gispert JD
J Alzheimers Dis
2018[]; 62
(3
): 1067-1077
PMID29562531
show ga
In the last decades, progress in neuroimaging techniques and cerebrospinal fluid
assays has enabled the characterization of several Alzheimer's disease (AD)
biomarkers. This knowledge has shifted the conceptualization of AD from a
clinical-pathological construct, where its diagnosis required the presence of
dementia with distinct pathologic features, toward a clinical-biological one that
recognizes AD as a pathological continuum with a clinical picture that ranges
from normal cognition to a dementia stage. Specifically, AD is now divided into
three stages: preclinical (abnormal biomarkers and no or only subtle cognitive
impairment), mild cognitive impairment or prodromal AD (abnormal
pathophysiological biomarkers and episodic memory impairment), and dementia
(abnormal biomarkers and clear cognitive and functional impairment). The
possibility of assessing AD pathophysiology in vivo before the onset of clinical
symptoms in the preclinical stage provides the unprecedented opportunity to
intervene at earlier stages of the continuum in secondary prevention trials.
Currently, large cohort studies of cognitively healthy participants are
undergoing with the main aim of disentangling the natural history of AD to
identify individuals with an increased risk of developing AD in the near future
to be recruited in these clinical trials. In this paper, we review how the
concept of AD has changed over the years as well as discuss the implications of
this conceptual change.
|*Alzheimer Disease/diagnosis/genetics/pathology/prevention & control
[MESH]