National Institute on Aging (NIA) – Alzheimer's Association Diagnostic Guidelines Focusing on the Three Stages of Alzheimer's Disease:
To access the guidelines or related resources, please visit the links below.
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The final versions of the guidelines, revised to reflect input from the professional community at large, now appear as free-access papers in Alzheimer's & Dementia®: The Journal of the Alzheimer's Association.
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Guideline commentary and free accessĮach workgroup initially issued proposed recommendations that were posted here for public comment. The neuropathologic guidelines recommend use of biomarker data to complement autopsy findings to help advance understanding of how closely biomarkers correlate with underlying physical processes. The guidelines for MCI due to Alzheimer's and Alzheimer's dementia also include research proposals for future use of biomarkers to increase diagnostic accuracy and optimize treatment. The FDA has approved aducanumab, the first FDA-approved drug that delays decline due to Alzheimer’s, as a treatment. Such treatments may be most effective if used as early as possible in the course of the illness. Identification of the newly defined preclinical stage of Alzheimer's will gain importance if researchers succeed in developing treatments that can slow or stop the progression of Alzheimer's. Biomarkers for Alzheimer's disease include brain imaging such as using magnetic resonance imaging (MRI) or positron emission tomography (PET), and proteins in cerebrospinal fluid (CSF). For example, blood glucose levels are a biomarker for diabetes, and blood cholesterol levels are a biomarker for heart disease. About biomarkersīiomarkers, such as those sought for Alzheimer's disease, are biological changes in the body that can be reliably measured to indicate the presence or absence of a disease, or the likelihood of later developing a disease. They propose a research agenda to identify biomarkers that may signal when these presymptomatic brain changes begin. The guidelines for this stage are research only and are not an immediate call for diagnosis of this preclinical stage and do not include specific diagnostic criteria. Current scientific evidence suggests that in preclinical Alzheimer's, brain changes caused by the disease may begin years - or even decades - before symptoms such as memory loss and confusion occur. In a "preclinical" disease stage, key biological changes are under way in the body, but the disease has not yet caused any noticeable "clinical" symptoms. The guidelines on preclinical Alzheimer's define this condition as a newly recognized hypothesis on preclinical stages. The guidelines for assessing brain changes during an autopsy can also be used now. Current and future recommended use of guidelinesĬore clinical diagnostic criteria spelled out in the guidelines for Alzheimer's dementia and MCI due to Alzheimer's can be used now in general practice. The fourth guideline updates criteria for documenting and reporting Alzheimer's-related changes observed during an autopsy. Three of the guidelines for research focus on three stages of Alzheimer's disease: (1) dementia due to Alzheimer's, (2) mild cognitive impairment (MCI) due to Alzheimer's, and (3) preclinical (presymptomatic) Alzheimer's. These criteria refine and broaden previous widely used guidelines jointly issued by the Alzheimer's Association and the NIH in 1984.īy incorporating new scientific insights and technological advances, the new guidelines aim to improve current diagnosis, strengthen autopsy reporting of Alzheimer's brain changes, and establish a research agenda for future progress in earlier detection and even greater diagnostic accuracy. National Institutes of Health (NIH), jointly issued four updated criteria and guidelines to diagnose Alzheimer's disease. Expert international workgroups convened by the Alzheimer's Association and the National Institute on Aging (NIA), an agency of the U.S.
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