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Chapter 12 - Biomarkers and the Diagnosis of Preclinical Alzheimer’s Disease

from Section 2 - Assessment and Investigations

Published online by Cambridge University Press:  12 September 2020

By
Philippa Lilford  and
Julian C Hughes
Edited by
Julian C. Hughes  and
Philippa Lilford
Julian C. Hughes
Affiliation:
University of Bristol
Philippa Lilford
Affiliation:
Severn Deanery, University of Bristol
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Summary

More than 47 million people are living with dementia worldwide, and this number is predicted to increase to 131 million by 2050. Not only can dementia be a devastating condition, it carries a large economic burden with a worldwide cost estimated at US$818 billion. With no cure and an ageing population, the increasing prevalence is a worry.

Biomarkers are naturally occurring markers of the underlying pathological process of a particular disease. Numerous biomarkers to detect Alzheimer’s disease (AD) have been developed over the past decade. These have helped to develop the theory that AD is a continuum, which starts with the accumulation of Alzheimer’s pathology years before the emergence of clinical symptoms. The continuum begins with a preclinical phase (Box 12.1), in which there are pathological changes of AD (which can be detected by biomarkers), but no symptoms of dementia. This stage may pre-date AD by decades. It is suggested that this progresses to a prodromal phase of mild symptoms that do not affect daily living. The final stage is established Alzheimer’s dementia. Moving through these stages is not inevitable, and biomarkers have been developed to help predict who will show progression along the continuum.

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Chapter
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Clinical Topics in Old Age Psychiatry , pp. 161 - 172
Publisher: Cambridge University Press
Print publication year: 2020

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