had a great article on the new research and diagnostic standards on Alzheimer’s disease.  The research shows gradual disease progression starting with changes in the brain, then mild memory problems and finally progressing to full-blown dementia.  The National Institute on Aging and the Alzheimer’s Association issued the guidelines which officially recognizes mild cognitive impairment or MCI as a precursor to the disease.  

Additionally, a new research category known as preclinical Alzheimer’s which is the earliest stage of the disease was recognized.  This preclinical stage about 10 years before dementia sets in is seen as the best place to intervene in the disease. It is why new imaging agents for PET scans, spinal fluid tests and other so-called biomarkers that predict Alzheimer’s are becoming so important to researchers and drug companies.  Formally recognizing the earlier phases of the disease is important in advancing Alzheimer’s research.

The new guidelines break the disease up into 3 stages:

Preclinical: There is evidence signs of Alzheimer’s disease may appear 10 years before the disease is diagnosed. These include brain changes, such as the buildup of the protein amyloid-beta, nerve cell damage and brain shrinkage. Some of these biomarkers might be detected in brain scans and proteins in spinal fluid. 

Mild cognitive impairment: A portion of those diagnosed with mild cognitive impairment will go on to develop Alzheimer’s disease. Biomarkers such as the use of MRI to detect brain shrinkage might be able to distinguish those who develop the disease from those who don’t. In addition, once researchers have ruled out other cases of cognitive impairment, such as a stroke or a tumor, biomarkers could be used to confirm the diagnosis of Alzheimer’s disease. 

Alzheimer’s dementia: These criteria expand the concept of Alzheimer’s dementia beyond just memory loss to include declines in other areas, such as vision/spatial problems, and impaired reasoning or judgment.



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