Reykjavík University, Reykjavík, Iceland.
Landspitali - The National University Hospital of Iceland (Memory Clinic), Reykjavík, Iceland.
Alzheimers Dement. 2023 May;19(5):2175-2181. doi: 10.1002/alz.12909. Epub 2023 Jan 13.
Clinical assessment remains the gold standard for diagnosing dementia, monitoring progression, and conducting clinical research. Biomarkers hold promise for targeted therapeutic approaches, selection of participants in clinical trials, and direct physiological efficacy readouts. However, the anchoring of biomarker research to clinical symptomatology is often based on short and insensitive cognitive screening. This gives the impression that cognitive symptoms occur relatively late and that their progression in the early stages of the disease is slow. A thorough cognitive assessment is a powerful tool and has a key role in the accurate and early diagnosis of dementia. It is very different from the cognitive testing usually seen in biomarker research and drug development. Yet the distinction between these approaches is unclear to many. This paper highlights the misconceptions around cognitive research in dementia and suggests a way forward to facilitate biomarker and drug development through the improved utility of cognitive assessment tools.
临床评估仍然是诊断痴呆、监测进展和进行临床研究的金标准。生物标志物有望用于靶向治疗方法、临床试验参与者的选择以及直接的生理疗效评估。然而，生物标志物研究与临床症状学的联系通常基于短期和不敏感的认知筛查。这给人一种印象，即认知症状发生相对较晚，并且在疾病的早期阶段进展缓慢。全面的认知评估是一种强大的工具，在痴呆的准确和早期诊断中起着关键作用。它与通常在生物标志物研究和药物开发中看到的认知测试有很大不同。然而，许多人对这些方法之间的区别并不清楚。本文强调了痴呆症认知研究中的误解，并提出了一种通过改进认知评估工具的使用来促进生物标志物和药物开发的方法。
