Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD‐ADRD): Executive summary of recommendations for primary care
Alzheimer s & Dementia,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 23, 2024
Abstract
US
clinical
practice
guidelines
for
the
diagnostic
evaluation
of
cognitive
impairment
due
to
Alzheimer's
disease
(AD)
or
AD
and
related
dementias
(ADRD)
are
decades
old
aimed
at
specialists.
This
evidence‐based
guideline
was
developed
empower
all—including
primary
care—clinicians
implement
a
structured
approach
evaluating
patient
with
symptoms
that
may
represent
AD/ADRD.
Through
modified‐Delphi
guideline‐development
process
(7374
publications
were
reviewed;
133
met
inclusion
criteria)
an
expert
workgroup
recommendations
as
steps
in
patient‐centered
process.
summary
focuses
on
recommendations,
appropriate
any
setting,
forming
core
elements
high‐quality,
evidence‐supported
characterizing,
diagnosing,
disclosing
patient's
functional
status,
cognitive–behavioral
syndrome,
likely
underlying
brain
so
optimal
care
plans
maximize
patient/care
partner
dyad
quality
life
can
be
developed;
companion
article
summarizes
specialist
recommendations.
If
clinicians
use
this
health‐care
systems
provide
adequate
resources,
outcomes
should
improve
most
patients
settings.
Highlights
Язык: Английский
The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD‐ADRD): Executive summary of recommendations for specialty care
Alzheimer s & Dementia,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 23, 2024
Abstract
US
clinical
practice
guidelines
for
the
diagnostic
evaluation
of
cognitive
impairment
due
to
Alzheimer's
disease
(AD)
or
a
related
dementia
(ADRD)
are
two
decades
old.
This
evidence‐based
guideline
was
developed
empower
all
clinicians
implement
structured
approach
evaluating
patient
with
symptoms
that
may
represent
AD/ADRD.
An
expert
workgroup
conducted
review
7374
publications
(133
met
inclusion
criteria)
and
recommendations
as
steps
in
an
process.
summary
briefly
reviews
core
details
specialist
high‐quality,
evidence‐supported
process
aimed
at
characterizing,
diagnosing,
disclosing
patient's
functional
status,
cognitive–behavioral
syndrome,
likely
underlying
brain
so
optimal
care
plans
maximize
patient/care
partner
dyad
quality
life
can
be
developed;
companion
article
summarizes
primary
recommendations.
If
use
this
health‐care
systems
provide
adequate
resources,
outcomes
should
improve
most
patients
settings.
Highlights
dementias
old
specialists.
all—including
care—clinicians
focuses
on
appropriate
specialty
settings,
forming
key
elements
Язык: Английский
The impact of pre-analytical factors on plasma biomarkers for Alzheimer's disease: The ASPREE Healthy Ageing Biobank
The Journal of Prevention of Alzheimer s Disease,
Год журнала:
2025,
Номер
unknown, С. 100058 - 100058
Опубликована: Фев. 1, 2025
The
conditions
under
which
samples
were
collected,
processed,
and
stored
in
biobanks
may
influence
Alzheimer's
disease
(AD)
biomarker
levels.
This
study
aims
to
investigate
whether
a
range
of
pre-analytical
factors
plasma
levels
AD
biomarkers.
Data
obtained
from
the
ASPREE
Healthy
Ageing
Biobank,
cohort
healthy
community-dwelling
older
individuals
aged
70+
years
Australia.
Five
biomarkers
measured
using
11,868
individuals:
phosphorylated-tau181
(p-tau181),
neurofilament
light
chain
(NfL),
glial
fibrillary
acidic
protein
(GFAP),
amyloid-beta
42
40
(Aβ42/Aβ40).
Linear
regression
examined
association
between
Participants
70-96
years,
54
%
female.
mean
storage
time
for
was
10.6
(range:
7.7-13.5).
Some
significant
associations
identified
biomarkers,
particular
p-tau181,
but
effect
sizes
small.
Weak
negative
found
p-tau181
venepuncture
laboratory
(transport)
(β:
-0.82,
p
=
0.03),
processing
frozen
(β:-1.56,
<
0.001),
total
-0.45,
0.007),
while
positive
with
intermediate
at
-20
°C/-30
°C
compared
-80
2.24,
0.004).
Longer
fasting
associated
higher
both
NfL
0.15,
0.001)
GFAP
1.75,
0.001).
Following
standard
operating
procedures,
can
be
up
13
minimal
impact
long-term
or
other
factors.
Язык: Английский
Older Amyloid Beta as a Candidate Blood Biomarker of Early Cognitive Decline in the Elderly—A Preliminary Study
Current Issues in Molecular Biology,
Год журнала:
2025,
Номер
47(3), С. 203 - 203
Опубликована: Март 18, 2025
(1)
Background/Objectives:
The
pathogenic
process
of
Alzheimer’s
disease
(AD)
is
known
to
begin
decades
before
its
clinical
onset.
This
period,
although
imperceptible
the
patient,
encompasses
a
gradual
neuronal
loss.
first
symptoms
dementia,
often
classified
as
mild
cognitive
impairment
(MCI),
in
many
cases
converts
into
incipient
AD,
but
can
also
remain
stable
or
even
reverse
norm.
An
easy
and
fast
blood-based
method
identifying
patients
at
risk
conversion
AD
would
allow
for
application
disease-altering
therapies.
preliminary
study
focuses
on
identification
assessment
relationship
between
plasma
amyloid
beta
(Aβ)
performance
older
Polish
adults
with
respect
adequacy
biomarker
an
early
deterioration.
(2)
Methods:
research
sample
consisted
230
participants,
109
females
121
males,
aged
65
plus.
association
Aβ
concentrations
status,
gender,
age
were
assessed.
analyses
conducted
three
categories
performance:
norm,
impairment,
based
results
Mini-Mental
State
Examination
(MMSE)
functional
tests.
(3)
Results:
No
significant
differences
levels
different
statuses
identified.
found
gender.
(4)
Conclusions:
In
order
thoroughly
explore
power
deterioration,
further
prospective
studies
are
required.
Язык: Английский
Cognitive Phenotyping and Interpretation of Alzheimer Blood Biomarkers
JAMA Neurology,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 4, 2025
Importance
Blood
phosphorylated
tau
217
(p-tau217)
showed
good
performance
in
predicting
brain
amyloidosis.
However,
the
importance
of
detailed
cognitive
phenotyping
patients
without
dementia
when
interpreting
p-tau217
results
remains
unclear.
Objective
To
assess
whether
accuracy,
negative
predictive
value
(NPV),
and
positive
(PPV)
amyloidosis
using
varies
across
clinical
presentations
dementia.
Design,
Setting,
Participants
The
study
design
included
2
observational,
prospective
cohort
studies:
Cohort
Outpatients
From
French
Research
Memory
Centers
Order
to
Improve
Knowledge
on
Alzheimer’s
Disease
Related
Disorders
(MEMENTO),
with
enrollment
from
2011
2014
5
years
follow-up,
Biomarker
Amyloid
Peptide
Risk
(BALTAZAR)
study,
2010
2015
3
follow-up.
Both
are
multicenter
cohorts
conducted
memory
clinics.
were
for
analysis
if
they
had
baseline
blood
measurement
a
known
amyloid
status
through
cerebrospinal
fluid
β
(Aβ)–42/Aβ-40
ratio
or
positron
emission
tomography.
They
presented
either
subjective
impairment
(SCI),
mild
(MCI)
common
Alzheimer
disease
(AD)
phenotype
(cAD-MCI:
amnestic
syndrome
hippocampal
type,
posterior
cortical
atrophy,
logopenic
primary
progressive
aphasia),
MCI
uncommon
AD
other
phenotypes
(uAD-MCI).
Data
analyzed
May
September
2024.
Exposures
concentrations.
Main
Outcomes
Measures
Brain
probabilities
derived
logistic
regressions
including
age,
gender,
APOE
genotype.
Published
internally
developed
cut
points
90%
sensitivity
specificity
used.
Results
A
total
776
participants
MEMENTO
(N
=
2323
participants)
193
BALTAZAR
1040)
this
analysis.
In
(median
[IQR]
71
[65-76]
years;
444
female
[57%]),
prevalence
was
16.5%
(20
121)
SCI,
45.9%
(78
170)
cAD-MCI,
24.5%
(119
485)
uAD-MCI.
Area
under
receiver
operating
characteristic
curve
models
0.78
(95%
CI,
0.66-0.89),
0.91
0.86-0.95),
0.87
0.84-0.91)
uAD-MCI
subgroups,
respectively.
External
resulted
PPV
60.0%,
90.0%,
74.5%
NPV
ranged
84.2%
90.2%.
With
points,
PPVs
52.6%,
84.0%,
72.3%
NPVs
high
(91.7%-94.6%)
all
subgroups.
Rates
incident
strongly
increased
probability
cAD-MCI
subgroup.
Replicated
analyses
provided
similar
results.
Conclusions
Relevance
suggest
that
varied
associated
diagnostic
determine
Comprehensive
beyond
basic
characterization
MCI,
should
accompany
use
biomarkers
practice
avoid
misdiagnosis
due
false
positives.
Язык: Английский
Plasma Biomarkers of Alzheimer’s Disease and Neurodegeneration According to Sociodemographic Characteristics and Chronic Health Conditions
The Journal of Prevention of Alzheimer s Disease,
Год журнала:
2024,
Номер
unknown
Опубликована: Янв. 1, 2024
Язык: Английский
Role of Blood P-Tau Isoforms (181, 217, 231) in Predicting Conversion from MCI to Dementia Due to Alzheimer’s Disease: A Review and Meta-Analysis
International Journal of Molecular Sciences,
Год журнала:
2024,
Номер
25(23), С. 12916 - 12916
Опубликована: Ноя. 30, 2024
Blood-based
biomarkers
are
minimally
invasive
tools
to
detect
the
pathological
changes
of
Alzheimer's
Disease
(AD).
This
meta-analysis
aims
investigate
use
blood-derived
p-tau
isoforms
(181,
217,
231)
predict
conversion
from
mild
cognitive
impairment
(MCI)
AD
dementia
(ADD).
Studies
involving
MCI
patients
with
data
on
blood
at
baseline
and
clinical
diagnosis
follow-up
(≥1
year)
were
included.
Twelve
studies
181
(4340
MCI,
rate
20.6%),
four
217
(913
33.4%),
one
231
(135
33%)
For
181,
pooled
area
under
receiver
operating
characteristic
curve
(AUC)
was
0.73
(95%
CI
=
0.68-0.78),
for
0.85
0.75-0.91).
Plasma
levels
had
good
discriminatory
power
identify
who
will
convert
ADD.
Although
only
have
been
included
in
meta-analysis,
last
year
predictive
is
emerging
as
superior
that
other
isoforms.
However,
given
high
heterogeneity
detected
this
additional
supportive
evidence
needed.
Insufficient
results
available
231.
These
findings
support
prognostic
utility
measured
progression
ADD
encourage
its
future
implementation
practice.
Язык: Английский
Plasma Alzheimer's disease biomarker variability: Amyloid‐independent and amyloid‐dependent factors
Alzheimer s & Dementia,
Год журнала:
2024,
Номер
21(1)
Опубликована: Ноя. 13, 2024
We
aimed
to
investigate
which
factors
affect
plasma
biomarker
levels
via
amyloid
beta
(Aβ)-independent
or
Aβ-dependent
effects
and
improve
the
predictive
performance
of
these
biomarkers
for
Aβ
positivity
on
positron
emission
tomography
(PET).
A
total
2935
participants
underwent
blood
sampling
measurements
Aβ42/40
ratio,
phosphorylated
tau
217
(p-tau217;
ALZpath),
glial
fibrillary
acidic
protein
(GFAP),
neurofilament
light
chain
(NfL)
using
single-molecule
array
PET.
Laboratory
findings
were
collected
a
routine
test
battery.
Aβ-independent
included
hemoglobin
estimated
glomerular
filtration
rate
(eGFR)
p-tau217
hemoglobin,
eGFR,
triiodothyronine
(T3)
GFAP
NfL.
apolipoprotein
E
genotypes,
body
mass
index
status
Aβ42/40,
p-tau217,
GFAP,
However,
exhibited
negligible
modest
Our
highlight
importance
accurately
interpreting
predicting
uptake
in
real-world
settings.
investigated
factor-Alzheimer's
disease
associations
large
Korean
cohort.
Hemoglobin
independently
brain
(Aβ).
Apolipoprotein
genotypes
dependent
Aβ.
Addition
shows
effect
positivity.
Adjusting
Язык: Английский
Lower Accuracy Alzheimer Disease Blood Tests Will Never Be “Ready for Prime Time”
Neurology,
Год журнала:
2024,
Номер
102(8)
Опубликована: Март 25, 2024
Язык: Английский
Precision Neurology
Ageing Research Reviews,
Год журнала:
2024,
Номер
unknown, С. 102632 - 102632
Опубликована: Дек. 1, 2024
Over
the
past
several
decades,
high-resolution
brain
imaging,
blood
and
cerebrospinal
fluid
analyses,
other
advanced
technologies
have
changed
diagnosis
from
an
exercise
depending
primarily
on
history
physical
examination
to
a
computer-
online
resource-aided
process
that
relies
larger
quantities
of
data.
In
addition,
randomized
controlled
trials
(RCT)
at
population
level
led
many
new
drugs
devices
treat
neurological
disease,
including
disease-modifying
therapies.
We
are
now
crossroads.
Combinatorially
profound
increases
in
data
about
individuals
has
alternative
population-based
RCTs.
Genotyping
comprehensive
"deep"
phenotyping
can
sort
into
smaller
groups,
enabling
precise
medical
decisions
personal
level.
neurology,
precision
medicine
includes
prediction,
prevention
personalization
requires
genomic
phenomic
information
further
incorporate
imaging
behavioral
this
article,
we
review
genomic,
phenomic,
computational
aspects
for
neurology.
After
defining
biological
markers,
discuss
some
applications
these
"-omic"
neuroimaging
measures,
then
outline
role
computation
ultimately
simulation.
conclude
article
with
discussion
relation
between
value-based
care.
Язык: Английский