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Title: | Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group. | Austin Authors: | Dubois, Bruno;Villain, Nicolas;Frisoni, Giovanni B;Rabinovici, Gil D;Sabbagh, Marwan;Cappa, Stefano;Bejanin, Alexandre;Bombois, Stéphanie;Epelbaum, Stéphane;Teichmann, Marc;Habert, Marie-Odile;Nordberg, Agneta;Blennow, Kaj;Galasko, Douglas;Stern, Yaakov;Rowe, Christopher C ;Salloway, Stephen;Schneider, Lon S;Cummings, Jeffrey L;Feldman, Howard H | Affiliation: | Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden Institut du Cerveau, Sorbonne University, Paris, France Cleveland Clinic, Lou Ruvo Center for Brain Health, Las Vegas, NV, USA Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA Department of Neurosciences, University of California San Diego, La Jolla, CA, USA Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, La Jolla, CA, USA Alzheimer Disease Cooperative Study, University of California San Diego, La Jolla, CA, USA Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden Theme Aging, The Aging Brain, Karolinska University Hospital, Stockholm, Sweden Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy Assistance Publique-Hôpitaux de Paris (AP-HP) Department of Neurology, Sorbonne University, Paris, France Institut du Cerveau, Sorbonne University, Paris, France INSERM, CHU Lille, U1171 - Degenerative and vascular cognitive disorders, University of Lille, Lille, France Inria ARAMIS project team, Inria-APHP collaboratio, Sorbonne University, Paris, France AP-HP Department of Nuclear Medicine, Sorbonne University, Paris, France CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Sorbonne University, Paris, France Assistance Publique-Hôpitaux de Paris (AP-HP) Department of Neurology, Sorbonne University, Paris, France Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland Memory Clinic, University Hospital of Geneva, Geneva, Switzerland Molecular Imaging and Therapy Cleveland Clinic, Lou Ruvo Center for Brain Health, Las Vegas, NV, USA Department of Neurosciences, University of California San Diego, La Jolla, CA, USA Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA Department of Neurology and Department of Psychiatry, Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA Keck School of Medicine of the University of Southern California, Los Angeles, USA Memory and Aging Center, Department of Neurology and Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA University School for Advanced Studies, Pavia, Italy; RCCS Mondino Foundation, Pavia, Italy |
Issue Date: | Jun-2021 | Date: | 2021-04-29 | Publication information: | The Lancet. Neurology 2021; 20(6): 484-496 | 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. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/26948 | DOI: | 10.1016/S1474-4422(21)00066-1 | Journal: | The Lancet. Neurology | PubMed URL: | 33933186 | Type: | Journal Article |
Appears in Collections: | Journal articles |
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