On the path to 2025: understanding the Alzheimer’s disease continuum

Alzheimer’s Research & Therapy

Reisa Sperling¹  Jeffrey Cummings²  Lutz Frölich³  Philip Scheltens⁴  Clifford R. Jack⁵  Joel Raskin⁶  Sherie A. Dowsett⁷  Brandy R. Matthews⁷  Bruno Dubois⁸  John C. Morris⁹  Roy W. Jones^1,10  Paul S. Aisen^1,11 

[1] Center for Alzheimer’s Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School;Cleveland Clinic Lou Ruvo Center for Brain Health;Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg;Department of Neurology & Alzheimer Center, VU University Medical Center;Department of Radiology, Mayo Clinic;Eli Lilly Canada Inc.;Eli Lilly and Company;Institute for Memory and Alzheimer’s Disease (IM2A) and ICM, Salpêtrière University Hospital, Paris University (UPMC);Knight Alzheimer Disease Research Center, Washington University School of Medicine;The Research Institute for the Care of Older People (RICE), Royal United Hospital;University of Southern California;

关键词: Alzheimer’s disease;    Amyloid beta;    Biomarker;    Cognitive impairment;    Clinical;    Continuum;   

DOI  :  10.1186/s13195-017-0283-5

来源: DOAJ

【 摘 要 】

Abstract Basic research advances in recent years have furthered our understanding of the natural history of Alzheimer’s disease (AD). It is now recognized that pathophysiological changes begin many years prior to clinical manifestations of disease and the spectrum of AD spans from clinically asymptomatic to severely impaired. Defining AD purely by its clinical presentation is thus artificial and efforts have been made to recognize the disease based on both clinical and biomarker findings. Advances with biomarkers have also prompted a shift in how the disease is considered as a clinico-pathophysiological entity, with an increasing appreciation that AD should not only be viewed with discrete and defined clinical stages, but as a multifaceted process moving along a seamless continuum. Acknowledging this concept is critical to understanding the development process for disease-modifying therapies, and for initiating effective diagnostic and disease management options. In this article, we discuss the concept of a disease continuum from pathophysiological, biomarker, and clinical perspectives, and highlight the importance of considering AD as a continuum rather than discrete stages. While the pathophysiology of AD has still not been elucidated completely, there is ample evidence to support researchers and clinicians embracing the view of a disease continuum in their study, diagnosis, and management of the disease.

【 授权许可】

Unknown