New Alzheimers diagnostic criteria proposed

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New diagnostic criteria for Alzheimer’s disease proposed by an international group of researchers and published in the October issue of Lancet Neurology, may allow for earlier detection and treatment of the condition.

The development of new guidelines was co-led by Howard Feldman, MD, head of the division of neurology at the University of British Columbia’s Faculty of Medicine. Feldman directs the Clinic for Alzheimer’s disease and Related Disorders at Vancouver Coastal Health in B.C. He co-authored the paper with French researcher Bruno Dubois, MD, and investigators from countries that include Japan, the United States and England.

The proposed criteria advocate the use of brain imaging techniques to examine the structure and function of the brain, as well as detecting the disease in spinal fluid. Early detection would help researchers test vaccines for Alzheimer’s and other drug treatments.

Existing criteria were established in 1984 and involve a two-step approach of evaluating functional disability and then looking for a cause. That delays diagnosis and treatment to a point that patients already have significant dementia symptoms. Advanced diagnostic tools available today should help diagnose and treat the disease before patients experience the disability of dementia.

New diagnostic measures include a clinical core of early, progressive and significant episodic memory loss plus one or more abnormal biomarkers characteristic of Alzheimer’s, including atrophy of the temporal lobe as shown on MR; abnormal amyloid beta protein concentrations in the cerebrospinal fluid; a specific pattern showing reduced glucose metabolism on PET scans of the brain; and a genetic mutation for Alzheimer’s within the immediate family.

Validation studies are needed to further explore the criteria and improve their sensitivity, specificity and accuracy, the researchers said.