title: Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease.
abstract: BACKGROUND
  Criteria for the clinical diagnosis of Alzheimer's disease (AD) were established in 1984. A broad consensus now exists that these criteria should be revised to incorporate state-of-the-art scientific knowledge.
  
  
  METHODS
  The National Institute on Aging (NIA) and the Alzheimer's Association sponsored a series of advisory round table meetings in 2009 whose purpose was to establish a process for revising diagnostic and research criteria for AD. The recommendation from these advisory meetings was that three separate work groups should be formed with each assigned the task of formulating diagnostic criteria for one phase of the disease: the dementia phase; the symptomatic, pre-dementia phase; and the asymptomatic, preclinical phase of AD.
  
  
  RESULTS
  Two notable differences from the AD criteria published in 1984 are incorporation of biomarkers of the underlying disease state and formalization of different stages of disease in the diagnostic criteria. There was a broad consensus within all three workgroups that much additional work is needed to validate the application of biomarkers for diagnostic purposes. In the revised NIA-Alzheimer's Association criteria, a semantic and conceptual distinction is made between AD pathophysiological processes and clinically observable syndromes that result, whereas this distinction was blurred in the 1984 criteria.
  
  
  CONCLUSIONS
  The new criteria for AD are presented in three documents. The core clinical criteria of the recommendations regarding AD dementia and MCI due to AD are intended to guide diagnosis in the clinical setting. However, the recommendations of the preclinical AD workgroup are intended purely for research purposes.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA. jack.clifford@mayo.edu
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Albert
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.forename: Guy M
authors.initials: GM
authors.lastname: McKhann
authors.forename: Reisa A
authors.initials: RA
authors.lastname: Sperling
authors.forename: Maria C
authors.initials: MC
authors.lastname: Carrillo
authors.forename: Bill
authors.initials: B
authors.lastname: Thies
authors.forename: Creighton H
authors.initials: CH
authors.lastname: Phelps
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D015415:Biomarkers / Q000134:cerebrospinal fluid; D015975:Consensus Development Conferences, NIH as Topic; D006287:Health Planning Guidelines; D006801:Humans; D054561:National Institute on Aging (U.S.) / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012955:Societies, Medical / Q000592:standards*; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers