Scientific article
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English

Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group

Published inLancet neurology, vol. 20, no. 6, p. 484-496
Publication date2021-06
First online date2021-04-29
Abstract

In 2018, the US National Institute on Aging and the Alzheimer's Association proposed a purely biological definition of Alzheimer's disease that relies on biomarkers. Although the intended use of this framework was for research purposes, it has engendered debate and challenges regarding its use in everyday clinical practice. For instance, cognitively unimpaired individuals can have biomarker evidence of both amyloid β and tau pathology but will often not develop clinical manifestations in their lifetime. Furthermore, a positive Alzheimer's disease pattern of biomarkers can be observed in other brain diseases in which Alzheimer's disease pathology is present as a comorbidity. In this Personal View, the International Working Group presents what we consider to be the current limitations of biomarkers in the diagnosis of Alzheimer's disease and, on the basis of this evidence, we propose recommendations for how biomarkers should and should not be used for diagnosing Alzheimer's disease in a clinical setting. We recommend that Alzheimer's disease diagnosis be restricted to people who have positive biomarkers together with specific Alzheimer's disease phenotypes, whereas biomarker-positive cognitively unimpaired individuals should be considered only at-risk for progression to Alzheimer's disease.

Keywords
  • Alzheimer Disease / diagnosis
  • Amyloid beta-Peptides / analysis
  • Amyloid beta-Peptides / metabolism
  • Biomarkers / analysis
  • Cognitive Dysfunction / diagnosis
  • Disease Progression
  • Humans
  • Phenotype
  • Tau Proteins / analysis
  • Tau Proteins / metabolism
Funding
  • NIA NIH HHS - [P20 AG068053]
  • NINDS NIH HHS - [U01 NS093334]
  • NIA NIH HHS - [P30 AG072980]
  • NIGMS NIH HHS - [P20 GM109025]
  • NIA NIH HHS - [R01 AG053798]
  • NIA NIH HHS - [P01 AG012435]
  • NIA NIH HHS - [P30 AG066530]
Citation (ISO format)
DUBOIS, Bruno et al. Clinical diagnosis of Alzheimer’s disease: recommendations of the International Working Group. In: Lancet neurology, 2021, vol. 20, n° 6, p. 484–496. doi: 10.1016/S1474-4422(21)00066-1
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Identifiers
Journal ISSN1474-4422
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Creation11/16/2022 12:30:20 PM
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