Department and Institute of Psychiatry, University of São Paulo, Brazil.
BMC Med. 2010 Dec 22;8:89. doi: 10.1186/1741-7015-8-89.
In view of the growing prevalence of Alzheimer's disease (AD) worldwide, there is an urgent need for the development of better diagnostic tools and more effective therapeutic interventions. At the earliest stages of AD, no significant cognitive or functional impairment is detected by conventional clinical methods. However, new technologies based on structural and functional neuroimaging, and on the biochemical analysis of cerebrospinal fluid (CSF) may reveal correlates of intracerebral pathology in individuals with mild, predementia symptoms. These putative correlates are commonly referred to as AD-related biomarkers. The relevance of the early diagnosis of AD relies on the hypothesis that pharmacological interventions with disease-modifying compounds are likely to produce clinically relevant benefits if started early enough in the continuum towards dementia. Here we review the clinical characteristics of the prodromal and transitional states from normal cognitive ageing to dementia in AD. We further address recent developments in biomarker research to support the early diagnosis and prediction of dementia, and point out the challenges and perspectives for the translation of research data into clinical practice.
鉴于全球范围内阿尔茨海默病（AD）的患病率不断上升，迫切需要开发更好的诊断工具和更有效的治疗干预措施。在 AD 的早期阶段，常规临床方法无法检测到明显的认知或功能损伤。然而，基于结构和功能神经影像学以及脑脊液（CSF）生化分析的新技术可能会揭示轻度、前驱期症状个体脑内病理学的相关性。这些所谓的相关性通常被称为 AD 相关生物标志物。AD 的早期诊断的相关性在于这样一种假设，即如果在向痴呆发展的连续体中足够早地开始使用具有疾病修饰作用的化合物进行药物干预，那么可能会产生临床相关的益处。在这里，我们回顾了从正常认知老化到 AD 痴呆的前驱期和过渡状态的临床特征。我们进一步探讨了生物标志物研究的最新进展，以支持痴呆的早期诊断和预测，并指出将研究数据转化为临床实践的挑战和前景。
