Forecasting the prevalence of preclinical and clinical Alzheimer's disease in the United States

Ron Brookmeyer,Nada Abdalla,Claudia H Kawas,María M Corrada

doi:10.1016/j.jalz.2017.10.009

Abstract

IntroductionWe forecast the prevalence of preclinical and clinical Alzheimer's disease (AD) and evaluated potential impacts of primary and secondary preventions in the United States. MethodsWe used a multistate model incorporating biomarkers for preclinical AD with US population projections. ResultsApproximately 6.08 million Americans had either clinical AD or mild cognitive impairment due to AD in 2017 and that will grow to 15.0 million by 2060. In 2017, 46.7 million Americans had preclinical AD (amyloidosis, neurodegeneration, or both), although many may not progress to clinical disease during their lifetimes. Primary and secondary preventions have differential impact on future disease burden. DiscussionBecause large numbers of persons are living with preclinical AD, our results underscore the need for secondary preventions for persons with existing AD brain pathology who are likely to develop clinical disease during their lifetimes as well as primary preventions for persons without preclinical disease.

Highlights

Knowledge of the pathogenesis of preclinical Alzheimer’s disease (AD) has grown enormously
The framework posits that the AD process typically begins with asymptomatic amyloidosis which refers to amyloid b (Ab) deposition which can be detected by specific biomarkers for Ab accumulation such as positron emission tomography amyloid imaging or low Ab
We estimate that the annual incidence of new cases of clinical AD in 2017 was 540,000 of whom approximately 89% arose from a state of mild cognitive impairment NOTE (MCI) with both amyloidosis and neurodegeneration while 11% arose from an MCI state with only neurodegeneration

Summary

Introduction

Knowledge of the pathogenesis of preclinical Alzheimer’s disease (AD) has grown enormously. Several National Institute on Aging and the Alzheimer’s Association (NIA-AA) joint working groups have developed guidelines for the stages of preclinical AD and revised criteria for diagnoses [1,2,3]. The preclinical period begins years before onset of clinical disease [4,5]. The diagnosis of persons with preclinical disease is potentially important because persons may be more likely to benefit from. R.B. reports fees from Takeda Inc. for serving as a member of a data safety monitoring board.

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Results

Conclusion