Alzheimer's disease(AD)is a common cause of dementia,characterised by cerebral amyloid-βdeposition,pathological tau and neurodegeneration.The prodromal stage of AD(pAD)refers to patients with mild cognitive impai...Alzheimer's disease(AD)is a common cause of dementia,characterised by cerebral amyloid-βdeposition,pathological tau and neurodegeneration.The prodromal stage of AD(pAD)refers to patients with mild cognitive impairment(MCl)and evidence of AD's pathology.At this stage,disease-modifying interventions should be used to prevent the progression to dementia.Given the inherent heterogeneity of MCl,more specific biomarkers are needed to elucidate the underlying AD's pathology.Although the uses of cerebrospinal fluid and positron emission tomography are widely accepted methods for detecting AD's pathology,their clinical applications are limited by their high costs and invasiveness,particularly in low-income areas in China.Therefore,to improve the early detection of Alzheimer's disease(AD)pathology through cost-effective screening methods,a panel of 45neurologists,psychiatrists andgerontologistswas invited to establish a formal consensus on the screening of pAD in China.The supportive evidence and grades of recommendations are based on a systematic literature review andfocus group discussion.National meetings were held to allow participants to review,vote and provide their expert opinions to reach a consensus.A majority(two-thirds)decision was used for questions for which consensus could not be reached.Recommended screening methods are presented in this publication,including neuropsychological assessment,peripheral biomarkers and brain imaging.In addition,a general workflow for Screening pAD in China is established,which will help clinicians identify individuals at high risk and determine therapeutic targets.展开更多
With the development of testing technologies,blood-based biomarkers for Alzheimer’s disease(AD)such as amyloid-β(Aβ),phosphorylated tau(P-tau),and neuro-filament light(NfL)have shown potential value in pre-dicting ...With the development of testing technologies,blood-based biomarkers for Alzheimer’s disease(AD)such as amyloid-β(Aβ),phosphorylated tau(P-tau),and neuro-filament light(NfL)have shown potential value in pre-dicting AD pathology and disease progression[1].To better interpret the detection results,it is essential to understand what factors would affect the concentrations of these biomarkers.While standardized testing meth-ods may reduce the influence of pre-analytical factors,demographic factors and clinical comorbidities may still affect blood biomarker levels[2,3].Previous studies have shown inconsistent results in this regard.For example,the apolipoprotein E(APOE)ε4 genotype was associated with a lower Aβ42/Aβ40 ratio in a cohort with different cognitive status but not in a population with or without AD[2,4].In a cohort where most participants had no cognitive impairment,males had higher plasma P-tau levels than females,whereas this was not the case in another group composed mostly of cognitively impaired participants[3,5].展开更多
基金the National Natural Science Foundation of China(82171198,U20A20354)the Sci-Tech Innovation 2030 Agenda of China(2022ZD0211603).
文摘Alzheimer's disease(AD)is a common cause of dementia,characterised by cerebral amyloid-βdeposition,pathological tau and neurodegeneration.The prodromal stage of AD(pAD)refers to patients with mild cognitive impairment(MCl)and evidence of AD's pathology.At this stage,disease-modifying interventions should be used to prevent the progression to dementia.Given the inherent heterogeneity of MCl,more specific biomarkers are needed to elucidate the underlying AD's pathology.Although the uses of cerebrospinal fluid and positron emission tomography are widely accepted methods for detecting AD's pathology,their clinical applications are limited by their high costs and invasiveness,particularly in low-income areas in China.Therefore,to improve the early detection of Alzheimer's disease(AD)pathology through cost-effective screening methods,a panel of 45neurologists,psychiatrists andgerontologistswas invited to establish a formal consensus on the screening of pAD in China.The supportive evidence and grades of recommendations are based on a systematic literature review andfocus group discussion.National meetings were held to allow participants to review,vote and provide their expert opinions to reach a consensus.A majority(two-thirds)decision was used for questions for which consensus could not be reached.Recommended screening methods are presented in this publication,including neuropsychological assessment,peripheral biomarkers and brain imaging.In addition,a general workflow for Screening pAD in China is established,which will help clinicians identify individuals at high risk and determine therapeutic targets.
基金supported by the National Natural Science Foundation of China(82171198)Shanghai Municipal Science and Technology Major Project and ZJLab(2018SHZDZX01)the Guangdong Provincial Key S&T Program(2018B030336001).
文摘With the development of testing technologies,blood-based biomarkers for Alzheimer’s disease(AD)such as amyloid-β(Aβ),phosphorylated tau(P-tau),and neuro-filament light(NfL)have shown potential value in pre-dicting AD pathology and disease progression[1].To better interpret the detection results,it is essential to understand what factors would affect the concentrations of these biomarkers.While standardized testing meth-ods may reduce the influence of pre-analytical factors,demographic factors and clinical comorbidities may still affect blood biomarker levels[2,3].Previous studies have shown inconsistent results in this regard.For example,the apolipoprotein E(APOE)ε4 genotype was associated with a lower Aβ42/Aβ40 ratio in a cohort with different cognitive status but not in a population with or without AD[2,4].In a cohort where most participants had no cognitive impairment,males had higher plasma P-tau levels than females,whereas this was not the case in another group composed mostly of cognitively impaired participants[3,5].
