Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria

Abstract

Abstract During the past decade, a conceptual shift occurred in the field of Alzheimer's disease (AD) considering the disease as a continuum. Thanks to evolving biomarker research and substantial discoveries, it is now possible to identify the disease even at the preclinical stage before the occurrence of the first clinical symptoms. This preclinical stage of AD has become a major research focus as the field postulates that early intervention may offer the best chance of therapeutic success. To date, very little evidence is established on this “silent” stage of the disease. A clarification is needed about the definitions and lexicon, the limits, the natural history, the markers of progression, and the ethical consequence of detecting the disease at this asymptomatic stage. This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations.

Keywords

Affiliated Institutions

• University of Gothenburg SE
• Harvard University US
• Barcelonaβeta Brain Research Center ES
• The University of Melbourne AU
• Sorbonne Université FR
• University College London GB
• Alzheimer's Association US
• UK Dementia Research Institute GB
• AXA Research Fund FR
• Istituti di Ricovero e Cura a Carattere Scientifico IT
• Lou Ruvo Brain Institute US
• Southern States University US
• Hope Center for Neurological Disorders US
• Federal Institute for Drugs and Medical Devices DE
• Karolinska Institutet SE
• Austin Health AU
• Centre National de la Recherche Scientifique FR
• Massachusetts General Hospital US
• Institute for Integrative and Experimental Genomics DE
• Centro San Giovanni di Dio Fatebenefratelli IT
• Imperial College London GB
• Amsterdam Neuroscience NL
• Amsterdam UMC Location Vrije Universiteit Amsterdam NL
• Mayo Clinic in Arizona US
• Institut de Psychiatrie et Neurosciences de Paris FR
• Brigham and Women's Hospital US
• Université Toulouse III - Paul Sabatier FR
• University Memory and Aging Center US
• University of North Texas US
• University Hospital and Clinics US
• Laboratoire d’Imagerie Biomédicale FR
• Consorci Institut D'Investigacions Biomediques August Pi I Sunyer ES
• University of Geneva CH
• University of British Columbia CA
• Brown University US
• Boston University US
• University Medical Center US
• Cleveland Clinic US
• Pasqual Maragall Foundation ES
• University of North Texas Health Science Center US
• Bordeaux Population Health FR
• Inserm FR
• Karolinska University Hospital SE
• University of Eastern Finland FI
• Sahlgrenska University Hospital SE
• Douglas Mental Health University Institute CA
• University of Lübeck DE
• Université de Bordeaux FR
• University Hospital of Geneva CH
• Pitié-Salpêtrière Hospital FR
• Butler Hospital US
• University of Southern California US
• Institut du Cerveau FR
• University of California, San Francisco US
• Université Fédérale de Toulouse Midi-Pyrénées FR

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