Abstract
Alzheimer’s disease (AD) is the most common form of dementia in the elderly, and it is characterized by progressive impairment in multiple cognitive domains of sufficient severity to interfere with individuals’ daily living activities. Historically, the diagnosis of AD has been based on the identification of a clinical syndrome, and accuracy studies of the current clinical criteria conducted in referral clinics have shown high sensitivity for AD. However, the identification of the disease is still not perfect, and there is growing evidence that the use of biomarkers will increase our ability to better indentify the underlying biology of AD, especially in its early stages. These biomarkers will improve the detection of the patients suitable for research studies and drug trials, and they will contribute to a better management of the disease in the clinical practice. In this review, we discuss the most studied biomarkers in AD: cerebrospinal fluid proteins, structural magnetic resonance imaging, functional neuroimaging techniques, and amyloid imaging.
Highlights
Alzheimer’s disease (AD) is the most frequent neurodegenerative disease (Ferri et al, 2005) and is characterized by a progressive dementia that occurs in middle or late life
The authors reported an increase in 11C-PIB brain retention in those control subjects with a positive baseline scan, suggesting a slow process of Aβ accumulation in the brain over time (Villemagne et al, 2011). These data are consistent with the hypothesis that amyloid imaging can detect Aβ accumulation in advance of the onset of dementia (Jack et al, 2010a), more longitudinal studies are required to determinate the sequence of pathological events in the process from normalcy to AD
Current data suggest that diagnosis of AD can be enhanced by use of these promising biomarkers to increase accuracy and identify early stages of the disease
Summary
Alzheimer’s disease (AD) is the most frequent neurodegenerative disease (Ferri et al, 2005) and is characterized by a progressive dementia that occurs in middle or late life. A more accurate and earlier diagnosis of AD (e.g., in MCI patients that will progress to the AD dementia phase or ideally those subjects in the pre-clinical phase) could enable the administration of potential disease-modifying drugs that would have a great impact on patients’ life and profound implications for public health (Brookmeyer et al, 1998). In this context, there is a need of specific biological markers for AD diagnosis in the earliest stages.
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