Toward defining the preclinical stages of Alzheimer's disease: Recommendations from the National Institute on Aging‐Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Abstract

The pathophysiological process of Alzheimer's disease (AD) is thought to begin many years before the diagnosis of AD dementia. This long “preclinical” phase of AD would provide a critical opportunity for therapeutic intervention; however, we need to further elucidate the link between the pathological cascade of AD and the emergence of clinical symptoms. The National Institute on Aging and the Alzheimer's Association convened an international workgroup to review the biomarker, epidemiological, and neuropsychological evidence, and to develop recommendations to determine the factors which best predict the risk of progression from “normal” cognition to mild cognitive impairment and AD dementia. We propose a conceptual framework and operational research criteria, based on the prevailing scientific evidence to date, to test and refine these models with longitudinal clinical research studies. These recommendations are solely intended for research purposes and do not have any clinical implications at this time. It is hoped that these recommendations will provide a common rubric to advance the study of preclinical AD, and ultimately, aid the field in moving toward earlier intervention at a stage of AD when some disease‐modifying therapies may be most efficacious.

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Affiliated Institutions

• Brigham and Women's Hospital US
• Massachusetts General Hospital US
• Harvard University US
• Geriatric Research Education and Clinical Center US
• Mayo Clinic US
• Rush University Medical Center US
• The University of Melbourne AU
• Banner Alzheimer’s Institute
• University of California, San Diego US
• University of Puget Sound US
• Alzheimer's Association US
• Columbia University US
• National Institute on Aging US
• University of California, Davis US
• University of Washington US
• The University of Texas at Dallas US
• Eli Lilly (United States) US
• The University of Tokyo JP
• University of California, San Francisco US
• Washington University in St. Louis US
• WinnMed US
• Austin Health AU

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