Alzheimer Diagnosis

A Simpler Alzheimer’s Diagnosis

One in 3 patients are currently given an incorrect diagnosis of Alzheimer’s disease (AD). A diagnosis of AD is typically determined by a suggestive clinical picture and confirmed or rejected by a biomarker.

Researchers have created a new algorithm comprised of 3 clinical scenarios and 2 biomarkers to simplify the diagnostic process, and make it more reliable.
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The 3 scenarios of the clinical picture include typical cases, atypical cases, and preclinical states:

  • In typical cases (80% to 85% of all cases) patients suffer impairment of episodic, long-term memory. Some symptoms include difficulty remembering a list of words.
  • Atypical cases (15% to 20% of cases) include frontal brain damage, which results in behavioral problems and impairment of verbal memory.
  • The preclinical states include patients without symptoms, but carry positive biomarkers.

One of 2 biomarkers—an elevated retention of amyloid tracer in the brain discovered by position emission tomography neuroimaging or abnormal levels of brain proteins in the cerebrospinal fluid (obtained through a lumbar puncture)—must be present in tandem with a clinical picture.

“We have reached the end of the road; we have arrived at the essence, something refined, resulting from an international consensus,” said Bruno Dubois, MD, professor of neurology at the French biomedical and public health research institution Inserm.

The complete list of diagnostic criteria is published in the June issue of The Lancet Neurology.

-Michelle Canales

References:

Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol. 2014 June [epub ahead of print] doi: 10.1016/S1474-4422(14)70090-0.

Inserm. Alzheimer’s disease: simplified diagnosis, with more reliable criteria [press release]. June 30, 2014. http://english.inserm.fr/press-area/alzheimer-s-disease-simplified-diagnosis-with-more-reliable-criteria. Accessed July 7, 2014.