Preclinical Alzheimer's dementia: a useful concept or another dead end?

IF 3.7 2区社会学 Q1 GERONTOLOGY European Journal of Ageing Pub Date : 2022-12-01 DOI:10.1007/s10433-022-00735-w

Ruth E Mark, Yvonne Brehmer

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引用次数: 4

Abstract

The term, preclinical dementia, was introduced in 2011 when new guidelines for the diagnosis of Alzheimer's dementia (AD) were published. In the intervening 11 years, many studies have appeared in the literature focusing on this early stage. A search conducted in English on Google Scholar on 06.23.2022 using the term "preclinical (Alzheimer's) dementia" produced 121, 000 results. However, the label is arguably more relevant for research purposes, and it is possible that the knowledge gained may lead to a cure for AD. The term has not been widely adopted by clinical practitioners. Furthermore, it is still not possible to predict who, after a diagnosis of preclinical dementia, will go on to develop AD, and if so, what the risk factors (modifiable and non-modifiable) might be. This Review/Theoretical article will focus on preclinical Alzheimer's dementia (hereafter called preclinical AD). We outline how preclinical AD is currently defined, explain how it is diagnosed and explore why this is problematic at a number of different levels. We also ask the question: Is the concept 'preclinical AD' useful in clinical practice or is it just another dead end in the Holy Grail to find a treatment for AD? Specific recommendations for research and clinical practice are provided.

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临床前阿尔茨海默氏痴呆症:一个有用的概念还是另一个死胡同?

“临床前痴呆”一词是在2011年阿尔茨海默氏痴呆症(AD)诊断新指南发表时引入的。在这中间的11年里，文献中出现了许多关注这个早期阶段的研究。2022年6月23日，在Google Scholar上用英语搜索“临床前(阿尔茨海默氏症)痴呆”一词，产生了121,000个结果。然而，这个标签可能与研究目的更相关，并且所获得的知识可能会导致治疗AD。该术语尚未被临床从业人员广泛采用。此外，在诊断出临床前痴呆后，仍然无法预测谁会继续发展为阿尔茨海默氏症，如果是的话，风险因素(可改变的和不可改变的)可能是什么。这篇综述/理论文章将重点关注临床前阿尔茨海默氏痴呆症(以下简称临床前AD)。我们概述了临床前阿尔茨海默病目前是如何定义的，解释了它是如何诊断的，并探讨了为什么在不同的层面上这是一个问题。我们还提出了一个问题:“临床前阿尔茨海默病”的概念在临床实践中有用吗?还是说它只是寻找阿尔茨海默病治疗方法的又一个死胡同?为研究和临床实践提供了具体建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Ageing GERONTOLOGY-

CiteScore

6.50

自引率

7.90%

发文量

期刊介绍： The European Journal of Ageing: Social, Behavioural and Health Perspectives is an interdisciplinary journal devoted to the understanding of ageing in European societies and the world over. EJA publishes original articles on the social, behavioral and population health aspects of ageing and encourages an integrated approach between these aspects. Emphasis is put on publishing empirical research (including meta-analyses), but conceptual papers (including narrative reviews) and methodological contributions will also be considered. EJA welcomes expert opinions on critical issues in ageing. By stimulating communication between researchers and those using research findings, it aims to contribute to the formulation of better policies and the development of better practice in serving older adults. To further specify, with the term ''social'' is meant the full scope of social science of ageing related research from the micro to the macro level of analysis. With the term ''behavioural'' the full scope of psychological ageing research including life span approaches based on a range of age groups from young to old is envisaged. The term ''population health-related'' denotes social-epidemiological and public health oriented research including research on functional health in the widest possible sense.