Alzheimer’s Disease – Course, natural history and prognosis

References:
1.APA Dictionary of Psychology Webpage. Disease course. Available at: https://dictionary.apa.org/disease-course. Accessed August 2023.

2.CDC Introduction to Epidemiology Webpage. Available at: https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section9.html. Access…

References:
1.Atri A. The Alzheimer’s disease clinical spectrum: diagnosis and management. Med Clin North Am 2019; 103 (2): 263–293.

2.Knopman DS, Amieva H, Petersen RC, et al. Alzheimer disease. Nat Rev Dis Primers 2021; 7 (1): 33.

3.DeTure MA, Dickson DW. The neuropathol…

The ‘preclinical’ stage precedes mild cognitive impairment (MCI) and includes individuals who have evidence of early AD pathological changes, but do not meet clinical criteria for MCI or dementia.⁷ Three stages of preclinical AD were first defined in 2011.⁷ In Stage 1, in…

References:
1.Reisberg B, Ferris SH, de Leon MJ, Crook T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139 (9): 1136–1139.

2.Olde Rikkert MG, Tona KD, Janssen L, et al. Validity, reliability, and feasibility of clini…

Disease stage can be based on aetiology, clinical history, anatomical distribution of pathology, or biological features.³ Clinically determined stages to categorize AD lack specificity, however they do provide prognostically relevant information.³ Numerical clinical stagi…

The severity of cognitive impairment in patients with AD varies.¹ Clinical diagnosis of cognitive impairment in individuals is important for the overall care of the individual.¹ There has been improvement in the level of awareness of dementia in primary care and specialis…

References:
1.Atri A. The Alzheimer’s disease clinical spectrum: diagnosis and management. Med Clin North Am 2019; 103 (2): 263–293.

2.Knopman DS, Amieva H, Petersen RC, et al. Alzheimer disease. Nat Rev Dis Primers 2021; 7 (1): 33.

3.Joubert S, Joncas S, Barbeau E, et al.…

The symptoms of AD can be generally divided into three categories – cognitive, functional, and neuropsychiatric. Cognitive symptoms in AD include memory, language, attention and executive functions, visuospatial skills and praxis (processing).² These impairments can manif…

Development of the National Institute on Aging (NIA)–Alzheimer’s Association (AA) research framework system for staging was designed to stage two types of information independently from each other – disease severity using biomarkers, and the severity of cognitive impairme…

In vivo neuroimaging data from neuropathological studies show a spatiotemporal development of Aβ deposits in the brain, which originates in the cerebral regions and spreads from the neocortex, to the allocortex, to the brainstem, finally reaching the cerebellum.^1,2 Aβ agg…

The staging method developed by Braak and Braak suggests that the neurofibrillary pathology of AD progresses in a relatively predictable sequence across the medial temporal lobe structures, subcortical nuclei, and neocortical areas of the brain in seven stages, with the f…

The time-course of biomarker abnormalities and the point at which they become detectable can help determine the primary cause of AD progression.³ The A/T/N biomarker classification system for AD includes three main classes of biomarkers – Ab, tau, and neurodegeneration – …

References:
1. Olde Rikkert MG, Tona KD, Janssen L, et al. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review. Am J Alzheimers Dis Other Demen 2011; 26 (5): 357–365.

2. Larson EB, Shadlen MF, Wang L, et al. Survival after ini…

References:
1. Petersen RC, Wiste HJ, Weigand SD, et al. NIA-AA Alzheimer’s disease framework: clinical characterization of stages. Ann Neurol 2021; 89 (6): 1145–1156.

2. Gauthier S, Reisberg B, Zaudig M, et al; International Psychogeriatric Association Expert Conference o…