Toward defining the preclinical stages of Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Reisa A. Sperling, Paul S. Aisen, Laurel A. Beckett, David A. Bennett, Suzanne Craft, Anne M. Fagan, Takeshi Iwatsubo, Clifford R. Jack, Jeffrey Kaye, Thomas J. Montine, Denise C. Park, Eric M. Reiman, Christopher C. Rowe, Eric Siemers, Yaakov Stern, Kristine Yaffe, Maria C. Carrillo, Bill Thies, Marcelle Morrison-Bogorad, Molly V. WagsterCreighton H. Phelps

Research output: Contribution to journalArticlepeer-review

5135 Scopus citations

Abstract

The pathophysiological process of Alzheimer's disease (AD) is thought to begin many years before the diagnosis of AD dementia. This long "preclinical" phase of AD would provide a critical opportunity for therapeutic intervention; however, we need to further elucidate the link between the pathological cascade of AD and the emergence of clinical symptoms. The National Institute on Aging and the Alzheimer's Association convened an international workgroup to review the biomarker, epidemiological, and neuropsychological evidence, and to develop recommendations to determine the factors which best predict the risk of progression from "normal" cognition to mild cognitive impairment and AD dementia. We propose a conceptual framework and operational research criteria, based on the prevailing scientific evidence to date, to test and refine these models with longitudinal clinical research studies. These recommendations are solely intended for research purposes and do not have any clinical implications at this time. It is hoped that these recommendations will provide a common rubric to advance the study of preclinical AD, and ultimately, aid the field in moving toward earlier intervention at a stage of AD when some disease-modifying therapies may be most efficacious.

Original languageEnglish (US)
Pages (from-to)280-292
Number of pages13
JournalAlzheimer's and Dementia
Volume7
Issue number3
DOIs
StatePublished - May 2011

Keywords

  • Amyloid
  • Biomarker
  • Neurodegeneration
  • Preclinical Alzheimer's disease
  • Prevention

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology

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