Taking the Next Steps in the Diagnosis of Alzheimer's Disease: The Use of Biomarkers

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S3) ◽  
pp. 7-10 ◽  
Author(s):  
Steven T. DeKosky
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Disease Progression ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Major Focus ◽  
Preclinical Phase ◽  
Risk Patients ◽  
Progressive Disorder

Alzheimer's disease (AD) is a progressive disorder in which neurodegeneration begins decades before clinical symptoms appear. Detecting AD during this preclinical phase presents both the enormous challenge of identifying at-risk patients prior to symptom onset and the potential reward of treating patients early enough to prevent or slow disease progression. Given that a 5-year delay in the onset of the clinical manifestations of AD could result in almost a 50% reduction in disease prevalence, early detection of AD is a major focus of clinical research. Several objective, measurable indicators of preclinical and clinical characteristics of AD are currently available or in development. These biomarkers are promising because they promote identification of individuals at risk for AD onset and disease progression; diagnostic accuracy and treatment during the early stages of AD; and the development of disease-modifying therapies that may potentially slow or prevent disease progression during the preclinical phase of AD.

scholarly journals Combining hippocampal volume metrics to better understand Alzheimer’s disease progression in at-risk individuals

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
K. McRae-McKee ◽  
S. Evans ◽  
C. Hadjichrysanthou ◽  
M. M. Wong ◽  
F. de Wolf ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Disease Progression ◽  
Hippocampal Volume

scholarly journals FROM BRAIN DISEASE TO BRAIN HEALTH: PRIMARY PREVENTION OF ALZHEIMER’S DISEASE AND RELATED DISORDERS IN A HEALTH SYSTEM USING AN ELECTRONIC MEDICAL RECORD-BASED APPROACH

2017 ◽  
pp. 1-8
Author(s):  
A.M. Fosnacht ◽  
S. Patel ◽  
C. Yucus ◽  
A. Pham ◽  
E. Rasmussen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Primary Prevention ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Brain Disease ◽  
Brain Health ◽  
Risk Patients

Background: Alzheimer’s disease and aging brain disorders are progressive, often fatal neurodegenerative diseases. Successful aging, modern lifestyles and behaviors have combined to result in an expected epidemic. Risks for these diseases include genetic, medical, and lifestyle factors; over 20 modifiable risks have been reported. Objectives: We aim to primarily prevent Alzheimer’s disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. Design: We identified modifiable risks; developed human, systems and infrastructural resources; developed interventions; and targeted at-risk groups for the intervention. Setting: A Community Based Health System. Participants: In year one (June 2015 to May 2016), 133 at-risk patients received brain health services with the goal of delaying or preventing Alzheimer’s disease and related disorders. Measurements: We created mechanisms to identify patients at high risk of neurodegenerative disease; EMR-based structured clinical documentation support tools to evaluate risk factors and history; evidence-based interventions to modify risk; and the capacity for annual surveillance, pragmatic trials, and practice-based and genomic research using the EMR. Results: This paper describes our Center for Brain Health, our EMR tools, and our first year of healthy but at-risk patients. Conclusion: We are translating research into primary prevention of Alzheimer’s disease and related disorders in our health system and aim to shift the paradigm in Neurology from brain disease to brain health.

scholarly journals Cerebral hypoperfusion is a late pathological event in the course of Alzheimer's disease

2021 ◽  
Author(s):  
Khazar Ahmadi ◽  
Joana B. Pereira ◽  
David Berron ◽  
Jacob Vogel ◽  
Silvia Ingala ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Disease Progression ◽  
Amyloid Β ◽  
Cognitive Status ◽  
Cerebral Hypoperfusion ◽  
Synaptic Dysfunction ◽  
Early Event ◽  
Preclinical Phase ◽  
Disease Progression Modeling

Although several studies have shown decreased cerebral blood flow (CBF) in Alzheimer's disease (AD), the role of hypoperfusion in the disease pathogenesis remains unclear. Combining arterial spin labeling MRI, positron emission tomography, and biomarkers of cerebrospinal fluid, we investigated the associations between CBF and the key mechanisms in AD including amyloid-β (Aβ) and tau pathology, synaptic dysfunction and axonal degeneration. Further, we applied a disease progression modeling to characterize the temporal sequence of different AD biomarkers. Lower perfusion was observed in the temporo-occipito-parietal regions in the Aβ-positive cognitively impaired compared to both the Aβ-positive and Aβ-negative cognitively unimpaired individuals. In participants along the AD spectrum (those with Aβ pathology regardless of their cognitive status), CBF was inversely associated with tau and synaptic dysfunction, but not Aβ in similar cortical regions. Moreover, the disease progression modeling revealed that CBF disruption followed the abnormality of biomarkers of Aβ, tau and brain atrophy. These findings indicate that tau tangles and synaptic degeneration are more closely connected with CBF changes rather than Aβ pathology. This supports the notion that hypoperfusion is not an early event associated with the build-up of Aβ during the preclinical phase of AD.

Altered Biological Rhythm and Alzheimer's Disease: A Bidirectional Relationship

2021 ◽  
Vol 18 ◽  
Author(s):  
Manli Wang ◽  
Hang Yu ◽  
Song Li ◽  
Yang Xiang ◽  
Weidong Le
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Biological Rhythms ◽  
Biological Rhythm ◽  
Common Symptom ◽  
Research Focus ◽  
Bidirectional Relationship ◽  
Research Findings

: Biological rhythms have become the research focus in recent years. Biological rhythm disruption is a common symptom of Alzheimer's disease (AD) patients, which is usually consid- ered as the late consequence of AD. Recent studies have shown that biological rhythm disruption even occurs before the onset of clinical symptoms of AD. The causal relationship between AD and biological rhythm disruption is not clear. Delineating their relationship can help understand the dis- ease mechanisms and make the early diagnosis of AD possible. This review integrates the research on the abnormal changes of the biological rhythm-related parameters in the clinical manifestations of AD patients and the roles of the biological rhythm disorders in AD. We will discuss the links be- tween biological rhythms and AD, with the focus on the bidirectionality between biological rhythms and AD processes. Collectively, these updated research findings may provide the basis for further exploring the significance of rhythm in the diagnosis and treatment of AD.

Neuroimaging and Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease

2017 ◽  
Author(s):  
Brian A. Gordon ◽  
Stephanie J.B. Vos ◽  
Anne M. Fagan
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Disease Progression ◽  
Amyloid Plaques ◽  
Blood Tests ◽  
Preclinical Phase ◽  
Disease Modifying Therapies ◽  
Cerebrospinal Fluid Biomarkers ◽  
Neuroimaging Techniques

Alzheimer’s disease is characterized by a long asymptomatic (preclinical) phase during which disease-related pathology accumulates in the absence of overt cognitive symptoms. The most prominent neuropathologies are extracellular amyloid plaques and intraneuronal neurofibrillary tangles. Until recently such pathology was observable only at autopsy. Now these, and other novel pathological markers, can be measured in living individuals using cerebrospinal fluid assays, blood tests, and neuroimaging techniques to track disease progression. Understanding changes in these biomarkers is critical for diagnosis, monitoring disease progression, and for the development of disease-modifying therapies. This chapter reviews the current scientific understanding regarding the use of biomarkers to assess Alzheimer’s disease pathology.

scholarly journals Novel strategies for the prevention of dementia from Alzheimer's disease

2009 ◽  
Vol 11 (2) ◽  
pp. 129-134
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Early Detection ◽  
Disease Progression ◽  
Clinical Symptoms ◽  
Health Care Systems ◽  
Detection Methods ◽  
Health Crisis ◽  
Care Systems ◽  
Treatment Research

As the world's population continues to age, Alzheimer's disease presents a looming public health crisis that, left unchecked, threatens to overwhelm health care systems throughout the developed world. In order to significantly tackle the most catastrophic and devastating symptom of Alzheimer's disease (AD)--dementia--we must be able to detect the disease prior to the onset of clinical symptoms, and be able to offer patients preventative treatments that block or significantly slow disease progression. This review summarizes a variety of the most promising early detection methods for Alzheimer's disease (AD) and mild cognitive impairment (MCI) that could be used to identify those at high risk of developing the disease and used for monitoring disease progression and response to investigational treatments. In addition, treatment research programs that could be developed into disease-modifying treatments that significantly delay the development of dementia are highlighted. These potential treatments target many different pathways, and may one day be dosed in combination to increase efficacy and prevent cognitive deterioration in patients with AD. While we still face numerous challenges, AD researchers have made great progress in understanding disease mechanisms. As we have seen in the treatment of heart disease, even modest preventative treatments can have hugely significant clinical outcomes and drastically reduce disease prevalence on a population scale. Therefore, there is hope that the development of prophylactic treatments, combined with improved early detection methods, will provide dramatic relief for millions of aging individuals threatened by the specter of Alzheimer's disease.

The Role of Neuroimaging in Fall Prevention in Healthy Adults at Risk of Alzheimer's Disease

2021 ◽  
pp. 107-129
Author(s):  
Albert Dayor Piersson ◽  
Wiam Elshami ◽  
Alberta Naa Afia Adjei ◽  
Klenam Dzefi-Tettey ◽  
Philip N. Gorleku
Keyword(s):  
Public Health ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Elderly People ◽  
Adult Population ◽  
Critical Role ◽  
Public Health Problem ◽  
The Elderly ◽  
Preclinical Phase

Falls are an important clinical, socioeconomic, and public health problem in the older adult population. Advancing age is a major risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD). The preclinical phase of AD, which is regarded as an important window for early therapeutic intervention before the onset of MCI and subsequently AD, can serve as a critical period to reduce or prevent falls among elderly people at risk of AD. In this chapter, first, a discussion is provided on the degrees of fall-related injuries, pain, and severity of falls in elderly people at risk of AD. Secondly, a discussion is provided on the clinical, socioeconomic, and public health implications of falls. Studies that integrated neuroimaging techniques were also reviewed to identify brain biomarkers that can be targeted for the prevention of falls among the elderly. It is anticipated that the outcome of this chapter may have a critical role in the prevention of falls among elderly people at risk or suffering from AD.

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