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

Autor: Lu J; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Wang J; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Wu J; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Zhang H; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Ma X; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Zhu Y; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Wang J; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Yang Y; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Xiao Z; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Li M; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Zhou X; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Ju Z; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Xu Q; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Ge J; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China., Ding D; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Center for Neurological Disorders, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Yen TC; APRINOIA Therapeutics Co. Ltd, Suzhou Industrial Park, Suzhou, China., Zuo C; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China.; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Center for Neurological Disorders, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; Human Phenome Institute, Fudan University, Pudong District, Shanghai, China., Guan Y; Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Xuhui District, Shanghai, China.; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Center for Neurological Disorders, Huashan Hospital, Fudan University, Jingan District, Shanghai, China., Zhao Q; Department and Institute of Neurology, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; National Center for Neurological Disorders, Huashan Hospital, Fudan University, Jingan District, Shanghai, China.; MOE Frontiers Center for Brain Science, Fudan University, Xuhui District, Shanghai, China.
Jazyk: angličtina
Zdroj: Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2024 Nov; Vol. 20 (11), pp. 7831-7846. Date of Electronic Publication: 2024 Sep 17.
DOI: 10.1002/alz.14245
Abstrakt: 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.
(© 2024 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
Databáze: MEDLINE
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