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New criteria and guidelines for the diagnosis of Alzheimer’s disease published

Tuesday 19 April 2011

A paper on the National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s disease has been published online by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The Alzheimer Association Research Center website states that criteria and guidelines include the following key elements:

 

  • An update of the 1984 diagnostic criteria for the dementia due to Alzheimer’s disease
  • A refinement to the existing guidelines for diagnosing mild cognitive impairment (MCI). This includes the guideline to identify MCI due to Alzheimer’s disease and defines four levels of certainty for arriving at this diagnosis
  • An expansion of the conceptual framework for thinking about Alzheimer’s disease to include a “preclinical” stage characterised by signature biological changes (biomarkers) that occur years before any disruptions in memory, thinking or behaviour can be detected. The biomarkers are not yet specified but a research agenda that builds on preliminary data is proposed.
  • The establishment of a framework for eventually adding biomarker benchmarks to the diagnosis of Alzheimer’s disease in all of its stages. Included in the guidelines is a proposal for a research agenda to increase diagnostic certainty by incorporating biomarkers into the diagnosis.

 

Creighton Phelps, Ph.D., Program Director of the Alzheimer’s Disease Centres Program at the National Institutes of Health said “The new guidelines reflect today’s understanding of how key changes in the brain lead to Alzheimer’s disease pathology and how they relate to the clinical signs of mild cognitive impairment and Alzheimer’s disease dementia. We are also beginning to be able to detect these changes at a preclinical stage, long before symptoms appear in many people. With further research on biomarkers, as set forth in the new guidelines, we may ultimately be able to predict who is at risk for development of mild cognitive impairment and Alzheimer’s dementia, and who would benefit most as interventions are developed.”

The “New Criteria and Guidelines for Alzheimer’s Disease Diagnosis” consist of four papers:

 

  • Introduction to the recommendations from the National Institute on Aging and the Alzheimer’s Association workgroup on diagnostic guidelines for Alzheimer’s disease
  • The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging and the Alzheimer’s Association workgroup
  • The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging and Alzheimer’s Association workgroup
  • Toward defining the preclinical stages of Alzheimer’s disease: Recommendations from the National Institute on Aging and the Alzheimer’s Association workgroup

 

In addition to the above articles, the results of deliberations from a workgroup set up to examine the post-mortem, pathological criteria for Alzheimer’s disease will be available in late 2011.

This publication incorporates comments received last year on the preliminary recommendations which were made during the Alzheimer’s Association International Conference on Alzheimer’s Disease (AAICAD) in July 2010 and it will be available in hard copy in the May 2011 issue of the journal Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association.

For further information please see the article “New criteria and guidelines for Alzheimer’s disease” on the Alzheimer’s Association website at:

http://www.alz.org/research/diagnostic_criteria/overview.asp?type=homepageflash

and the four articles on the Alzheimer’s Association website at:

http://www.alzheimersanddementia.org/content/ncg

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