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阿尔茨海默病协会工作组在三级记忆诊所中对阿尔茨海默病分期修订标准的初步实施。

Pilot implementation of the revised criteria for staging of Alzheimer's disease by the Alzheimer's Association Workgroup in a tertiary memory clinic.

机构信息

Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China.

Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.

出版信息

Alzheimers Dement. 2024 Nov;20(11):7831-7846. doi: 10.1002/alz.14245. Epub 2024 Sep 17.

DOI:10.1002/alz.14245
PMID:39287564
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11567817/
Abstract

INTRODUCTION

We aimed to evaluate the feasibility of the 2024 Alzheimer's Association Workgroup's integrated clinical-biological staging scheme in outpatient settings within a tertiary memory clinic.

METHODS

The 2018 syndromal cognitive staging system, coupled with a binary biomarker classification, was implemented for 236 outpatients with cognitive concerns. The 2024 numeric clinical staging framework, incorporating biomarker staging, was specifically applied to 154 individuals within the Alzheimer's disease (AD) continuum.

RESULTS

The 2024 staging scheme accurately classified 95.5% AD. Among these, 56.5% exhibited concordant clinical and biological stages (canonical), 34.7% demonstrated more advanced clinical stages than biologically expected (susceptible), and 8.8% displayed the inverse pattern (resilient). The susceptible group was characterized by a higher burden of neurodegeneration and inflammation than anticipated from tau, whereas the resilient group showed the opposite.

DISCUSSION

The 2024 staging scheme is generally feasible. A discrepancy between clinical and biological stages is relatively frequent among symptomatic patients with AD.

HIGHLIGHTS

The 2024 AA staging scheme is generally feasible in a tertiary memory clinic. A discrepancy between clinical and biological stages is relatively frequent in AD. The mismatch may be influenced by a non-specific pathological process involved in AD. Individual profiles like aging and lifestyles may contribute to such a mismatch. Matched and mismatched cases converge toward similar clinical outcomes.

摘要

简介

我们旨在评估 2024 年阿尔茨海默病协会工作组在三级记忆诊所的门诊环境中实施综合临床-生物学分期方案的可行性。

方法

为 236 名有认知问题的门诊患者实施了 2018 年综合征认知分期系统，结合二元生物标志物分类。针对阿尔茨海默病（AD）连续体中的 154 名个体，特别应用了 2024 年数值临床分期框架，包括生物标志物分期。

结果

2024 分期方案准确地将 95.5%的 AD 进行了分类。其中，56.5%的患者具有一致的临床和生物学分期（典型），34.7%的患者具有比生物学预期更高级的临床分期（易感），8.8%的患者具有相反的模式（抵抗）。易感组的神经退行性变和炎症负担比预期的 tau 更高，而抵抗组则相反。

讨论

2024 分期方案总体上是可行的。在有症状的 AD 患者中，临床和生物学分期之间的差异相对常见。

重点

2024 年 AA 分期方案在三级记忆诊所中总体上是可行的。在 AD 中，临床和生物学分期之间的差异相对常见。这种不匹配可能受 AD 中涉及的非特异性病理过程的影响。像衰老和生活方式等个体特征可能导致这种不匹配。匹配和不匹配的病例都趋向于相似的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/66accba53b56/ALZ-20-7831-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/1ce508e56648/ALZ-20-7831-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/ee207a78d2da/ALZ-20-7831-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/00b018c04558/ALZ-20-7831-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/35e5535f918d/ALZ-20-7831-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/66accba53b56/ALZ-20-7831-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/1ce508e56648/ALZ-20-7831-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/ee207a78d2da/ALZ-20-7831-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/00b018c04558/ALZ-20-7831-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/35e5535f918d/ALZ-20-7831-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65a2/11567817/66accba53b56/ALZ-20-7831-g004.jpg

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