title: Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria.
abstract: The NINCDS-ADRDA and the DSM-IV-TR criteria for Alzheimer's disease (AD) are the prevailing diagnostic standards in research; however, they have now fallen behind the unprecedented growth of scientific knowledge. Distinctive and reliable biomarkers of AD are now available through structural MRI, molecular neuroimaging with PET, and cerebrospinal fluid analyses. This progress provides the impetus for our proposal of revised diagnostic criteria for AD. Our framework was developed to capture both the earliest stages, before full-blown dementia, as well as the full spectrum of the illness. These new criteria are centred on a clinical core of early and significant episodic memory impairment. They stipulate that there must also be at least one or more abnormal biomarkers among structural neuroimaging with MRI, molecular neuroimaging with PET, and cerebrospinal fluid analysis of amyloid beta or tau proteins. The timeliness of these criteria is highlighted by the many drugs in development that are directed at changing pathogenesis, particularly at the production and clearance of amyloid beta as well as at the hyperphosphorylation state of tau. Validation studies in existing and prospective cohorts are needed to advance these criteria and optimise their sensitivity, specificity, and accuracy.
authors.affiliation: INSERM U610, Hôpital de la Salpêtrière, Paris, France. bruno.dubois@psl.aphp.fr
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.forename: Howard H
authors.initials: HH
authors.lastname: Feldman
authors.forename: Claudia
authors.initials: C
authors.lastname: Jacova
authors.forename: Steven T
authors.initials: ST
authors.lastname: Dekosky
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cummings
authors.forename: André
authors.initials: A
authors.lastname: Delacourte
authors.forename: Douglas
authors.initials: D
authors.lastname: Galasko
authors.forename: Serge
authors.initials: S
authors.lastname: Gauthier
authors.forename: Gregory
authors.initials: G
authors.lastname: Jicha
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
authors.forename: John
authors.initials: J
authors.lastname: O'brien
authors.forename: Florence
authors.initials: F
authors.lastname: Pasquier
authors.forename: Philippe
authors.initials: P
authors.lastname: Robert
authors.forename: Martin
authors.initials: M
authors.lastname: Rossor
authors.forename: Steven
authors.initials: S
authors.lastname: Salloway
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Visser
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
mesh_terms: D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D003952:Diagnostic Imaging / Q000379:methods; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D006801:Humans; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D009316:National Institutes of Health (U.S.) / Q000592:standards; D012720:Severity of Illness Index; D013997:Time Factors; D014481:United States; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D016875:tau Proteins