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Alzheimers Dement. 2017 Apr;13(4):468-492. doi: 10.1016/j.jalz.2016.06.2365. Epub 2016 Oct 1.

Detecting cognitive changes in preclinical Alzheimer's disease: A review of its feasibility.

Author information

1
Institut National de la Santé et de la Recherche Médicale, U1061 Neuropsychiatrie, Montpellier, France; Faculty of Medicine, University of Montpellier, Montpellier, France.
2
Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
3
Metis Cognition Ltd, Kilmington Common, UK; Alzheimer Center VUmc, Amsterdam, the Netherlands.
4
Neurology and Biomedical Engineering, Oregon Health and Science University, Portand, OR, USA.
5
Department of Neurology Memory and Ageing Centre, University of California at San Francisco, San Francisco, CA, USA.
6
Department of Neurology, Loyola University Medical Center, Maywood, IL, USA.
7
Institut National de la Santé et de la Recherche Médicale, U1061 Neuropsychiatrie, Montpellier, France.
8
Clinical Research, Neuroscience and General Medicine, Eisai Inc, Woodcliff Lake, NJ, USA.
9
Clinical Research, Neurosciences, Janssen, South San Francisco, CA, USA.
10
Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK.
11
Institut National de la Santé et de la Recherche Médicale, U1061 Neuropsychiatrie, Montpellier, France; Faculty of Medicine, University of Montpellier, Montpellier, France; Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK. Electronic address: karen.ritchie@inserm.fr.

Abstract

Significant progress has been made in characterizing the biological changes occurring in preclinical Alzheimer's disease (AD). Cognitive dysfunction has been viewed, however, as a late-stage phenomenon, despite increasing evidence that changes may be detected in the decades preceding dementia. In the absence of comprehensive evidence-based guidelines for preclinical cognitive assessment, longitudinal cohort and neuroimaging studies have been reviewed to determine the temporal order and brain biomarker correlates of specific cognitive functions. Episodic memory decline was observed to be the most salient cognitive function, correlating with high levels of amyloid deposition and hypoconnectivity across large-scale brain networks. Prospective studies point to early decline in both episodic and semantic memory processing as well as executive functions in the predementia period. The cognitive tests have, however, been principally those used to diagnose dementia. New procedures are required which target more finely the medial temporal lobe subregions first affected by clinically silent AD pathology.

KEYWORDS:

Alzheimer's disease; Cognition; Diagnosis; Neuropsychology; Preclinical markers

PMID:
27702618
DOI:
10.1016/j.jalz.2016.06.2365
[Indexed for MEDLINE]

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