Department of Neurology, Washington University School of Medicine, St. Louis, St. Louis,Missouri, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis,St. Louis, Missouri, USA; The Knight Alzheimer’s Disease Research Center, Washington University School of Medicine,St. Louis, St. Louis, Missouri, USA.
Cold Spring Harb Perspect Med. 2012 May;2(5):a006148. doi: 10.1101/cshperspect.a006148.
Alzheimer disease (AD) is the most common cause of dementia in the elderly. Clinicopathological studies support the presence of a long preclinical phase of the disease, with the initial deposition of AD pathology estimated to begin approximately 10-15 years prior to the onset of clinical symptoms. The hallmark clinical phenotype of AD is a gradual and progressive decline in two or more cognitive domains, most commonly involving episodic memory and executive functions, that is sufficient to cause social or occupational impairment. Current diagnostic criteria can accurately identify AD in the majority of cases. As disease-modifying therapies are being developed, there is growing interest in the identification of individuals in the earliest symptomatic, as well as presymptomatic, stages of disease, because it is in this population that such therapies may have the greatest chance of success. The use of informant-based methods to establish cognitive and functional decline of an individual from previously attained levels of performance best allows for the identification of individuals in the very mildest stages of cognitive impairment.
阿尔茨海默病（AD）是老年人中最常见的痴呆症病因。临床病理研究支持疾病存在很长的临床前期，AD 病理的最初沉积估计在临床症状出现前约 10-15 年开始。AD 的标志性临床表型是两个或更多认知领域的逐渐和进行性下降，最常见的是涉及情景记忆和执行功能，这足以导致社交或职业障碍。目前的诊断标准可以在大多数情况下准确识别 AD。随着疾病修饰疗法的发展，人们越来越关注识别最早出现症状以及无症状前阶段的个体，因为在这些人群中，这些疗法可能有最大的成功机会。使用基于信息提供者的方法来确定个体相对于之前表现水平的认知和功能下降，最有利于识别认知障碍最轻微阶段的个体。
