Abstract
There have been several newly proposed sets of diagnostic criteria for Alzheimer's disease/mild cognitive impairment, advanced by the National Institute of Aging/Alzheimer's Association working groups in 2011 and by the International Working Group in 2007 and 2010. These sets each aim to provide broader disease stage coverage with incorporation of disease biomarkers into the diagnostic process. They have focused particular attention on the earlier identification of disease with focus on the preclinical and predementia stages. This paper reviews these diagnostic criteria and provides 2012 consensus recommendations from the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia on their applications in both clinical and research settings.
Highlights
This report was prepared for the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCD) held in May 2012 in Montreal, Canada
The potential for earlier Alzheimer’s disease (AD) diagnosis has been supported by the advent of promising in vivo cerebrospinal fluid (CSF) measures of amyloid-beta (Aβ) 1 to 40, amyloid beta (Aβ) 1 to 42, total tau and phospho-tau, and neuroimaging biomarkers – structural magnetic resonance imaging (MRI), amyloid positron emission tomography (PET), fludeoxyglucose (FDG) PET – that reflect the presence of the AD pathophysiological process (AD-P)
While these biomarkers enable the identification of AD-P in vivo, there is still much to learn about their significance in asymptomatic individuals and the associated increased risk of progression to AD dementia
Summary
This report was prepared for the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCD) held in May 2012 in Montreal, Canada. The diagnostic criteria for possible vascular dementia are fulfilled if there is no clear relationship between cognitive impairment and cerebrovascular disease, if the information available is insufficient or clinical symptoms preclude assessment, or if there is evidence of a concomitant neurodegenerative process that may contribute to the cognitive impairment These criteria do not require the traditional stepwise progression of cognitive impairment associated with multi-infarct dementia, and they are not conditional on memory impairment being present. Abbreviations Aβ, amyloid beta; AD, Alzheimer disease; AD-P, Alzheimer disease pathophysiological process; AHA, American Heart Association; ASA, American Stroke Association; CCCD, Canadian Consensus Conference on the Diagnosis and Treatment of Dementia; CSF, cerebrospinal fluid; FDG, fludeoxyglucose; IWG, International Working Group; MCI, mild cognitive impairment; MRI, magnetic resonance imaging; NIA-AA, National Institute of Aging/Alzheimer’s Association; PET, positron emission tomography; VCI, vascular cognitive impairment. Competing interests The authors declare that they have no competing interests
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