Predementic diagnosis and biomarkers of dementia in Alzheimer's disease

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2012
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NOVA SCIENCE PUBLISHERS, INC.
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Forlenza, O. V.; Diniz, B. S.; Gattaz, W. F.. Predementic diagnosis and biomarkers of dementia in Alzheimer's disease. In: . RESEARCH PROGRESS IN ALZHEIMER'S DISEASE AND DEMENTIA (V): NOVA SCIENCE PUBLISHERS, INC., 2012. p.113-140.
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In next decades, Alzheimer's disease (AD) will reach an epidemic status unless more effective therapeutic interventions are made available. These treatments should target the modification of specific pathological cascades that lead to neurodegeneration in AD. There is evidence of a long pre-clinical stage in AD, in which neuritic plaques and neurofibrillary tangles gradually accumulate in affected brain areas. At the earliest stages of this process, no significant cognitive or functional impairment is detected by conventional clinical methods. New technologies based on structural and functional neuroimaging, and on the biochemical analysis of cerebrospinal fluid may depict correlates of intracerebral pathology in individuals with mild, pre-dementia symptoms. These methods are commonly referred to as AD-related biomarkers. Therefore, the combination of clinical and biological information yields better diagnostic accuracy to identify individuals at high risk of AD. The relevance of this diagnosis relies on the hypothesis that pharmacological interventions with disease-modifying compounds are likely to produce clinically relevant benefits if started early enough in the continuum towards dementia. In this paper, we review the clinical characteristics of the prodromal and transitional states from normal cognitive ageing to dementia in AD. We further address recent developments in biomarker research to support the early diagnosis and prediction of dementia, and discuss the challenges and perspectives for the development of disease-modifying therapies. © 2012 by Nova Science Publishers, Inc. All rights reserved.
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Alzheimer's disease, Amyloid-β protein, Biomarkers, Mild cognitive impairment, Neuroimaging, Pathophysiology, Tau protein
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