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Preclinical Alzheimer disease: identification of cases at risk among cognitively intact older individuals

Publié dansBMC medicine, vol. 10, 127
Date de publication2012
Résumé

Since the first description of the case of Auguste Deter, presented in Tübingen in 1906 by Alois Alzheimer, there has been an exponential increase in our knowledge of the neuropathological, cellular, and molecular foundation of Alzheimer's disease (AD). The concept of AD pathogenesis has evolved from a static, binary view discriminating cognitive normality from dementia, towards a dynamic view that considers AD pathology as a long-lasting morbid process that takes place progressively over years, or even decades, before the first symptoms become apparent, and thus operating in a continuum between the two aforementioned extreme states. Several biomarkers have been proposed to predict AD-related cognitive decline, initially in cases with mild cognitive impairment, and more recently in cognitively intact individuals. These early markers define at-risk individuals thought to be in the preclinical phase of AD. However, the clinical relevance of this preclinical phase remains controversial. The fate of such individuals, who are cognitively intact, but positive for some early AD biomarkers, is currently uncertain at best. In this report, we advocate the point of view that although most of these preclinical cases will evolve to clinically overt AD, some appear to have efficient compensatory mechanisms and virtually never develop dementia. We critically review the currently available early AD markers, discuss their clinical relevance, and propose a novel classification of preclinical AD, designating these non-progressing cases as 'stable asymptomatic cerebral amyloidosis'.

Mots-clés
  • Alzheimer Disease/diagnosis/pathology
  • Asymptomatic Diseases
  • Biological Markers
  • Cerebral Amyloid Angiopathy/diagnosis
  • Dementia/diagnosis
  • Humans
  • Risk Assessment
Citation (format ISO)
LAZARCZYK, Maciej J et al. Preclinical Alzheimer disease: identification of cases at risk among cognitively intact older individuals. In: BMC medicine, 2012, vol. 10, p. 127. doi: 10.1186/1741-7015-10-127
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Article (Published version)
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Identifiants
ISSN du journal1741-7015
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Informations techniques

Création09/12/2013 19:59:00
Première validation09/12/2013 19:59:00
Heure de mise à jour14/03/2023 20:42:15
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