Neurológia pre prax 4/2016

Alzheimer’s disease as a neuropathological continuum in clinical practice. How did we improve the diagnosis since 1984 and why we don’t have a causal therapy yet?

In 2011, new guidelines for the diagnosis of Alzheimer’s disease (AD) based on biomarker assessment were published. They define AD as a neuropathological continuum independently of the clinical symptoms of the patient. They describe three clinical stages – preclinical with AD pathology only, prodromal with AD pathology and mild cognitive impairment and dementia stage. We evaluate the benefits and pitfalls of particular biomarker examinations, their availability and benefits for clinical practice and the ethical impact of early diagnosis in the light of so far unavailable causal therapy. We present recommendations for clinical practice emanating from the international harmonized guidelines from 2014.

Keywords: Alzheimer’s disease, biomarkers, diagnostic criteria