title: Evolution of the diagnostic criteria for degenerative and cognitive disorders.
abstract: OBJECTIVE
  This review describes the evolution of the clinical criteria for Alzheimer's disease over the past 25 years, with special emphasis on those recently published that have incorporated the use of biomarkers.
  
  
  RESULTS
  One of the most important advances in the knowledge of Alzheimer's disease was the development of cerebrospinal fluid, PET and MRI biomarkers. These have shown that the Alzheimer's disease is present in cognitively normal individuals, suggesting that there is a long incubation process that precedes the onset of the symptoms. Although there are diagnostic criteria for Alzheimer's disease, the National Institute on Aging and the Alzheimer's Association has proposed a set of diagnostic criteria oriented to provide a unified vision of the pathological process from preclinical, to mild cognitive impairment, and to full-blown dementia. These new criteria take advantage of different biomarkers to support the clinical diagnosis of the different stages of the disease.
  
  
  CONCLUSIONS
  The new guidelines provide a definition of the dementia syndrome and core diagnostic features to be used in research and clinical practice, although they caution about the use of biomarkers, since they still require validation, and the longitudinal interaction and dynamics of these biomarkers in relationship to the manifestation of the symptoms are not fully understood.
authors.affiliation: Department of Neurology, Alzheimer's Disease Research Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Lopez
authors.forename: Eric
authors.initials: E
authors.lastname: McDade
authors.forename: Mario
authors.initials: M
authors.lastname: Riverol
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D015415:Biomarkers / Q000378:metabolism; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003704:Dementia / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008568:Memory / Q000502:physiology; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
references.citation: Annu Rev Neurosci. 1980;3:77-95
references.pmid: 6251745
references.citation: Dement Geriatr Cogn Disord. 1998 Jul-Aug;9(4):219-26
references.pmid: 9681644
references.citation: J Neurol Sci. 1990 Mar;95(3):239-58
references.pmid: 2358819
references.citation: Neurology. 2004 Dec 28;63(12):2341-7
references.pmid: 15623697
references.citation: N Engl J Med. 1996 Mar 21;334(12):752-8
references.pmid: 8592548
references.citation: J Neurol Neurosurg Psychiatry. 1994 Apr;57(4):416-8
references.pmid: 8163988
references.citation: Neurology. 1996 Jul;47(1):1-9
references.pmid: 8710059
references.citation: AJNR Am J Neuroradiol. 2010 May;31(5):847-55
references.pmid: 20075093
references.citation: Arch Neurol. 2008 Nov;65(11):1509-17
references.pmid: 19001171
references.citation: Arch Neurol. 1994 Dec;51(12):1198-204
references.pmid: 7986174
references.citation: Neurology. 2003 Apr 8;60(7):1089-93
references.pmid: 12682311
references.citation: Arch Neurol. 2003 Dec;60(12):1696-702
references.pmid: 14676043
references.citation: Neurology. 2008 Dec 9;71(24):1986-92
references.pmid: 19064880
references.citation: Int Psychogeriatr. 1998 Sep;10(3):271-302
references.pmid: 9785148
references.citation: Ann Neurol. 2009 May;65(5):557-68
references.pmid: 19475670
references.citation: J Am Geriatr Soc. 1999 May;47(5):564-9
references.pmid: 10323650
references.citation: Neurology. 1997 Sep;49(3):786-94
references.pmid: 9305341
references.citation: Arch Neurol. 1987 Jan;44(1):24-9
references.pmid: 3800717
references.citation: J Intern Med. 2004 Sep;256(3):183-94
references.pmid: 15324362
references.citation: Neurology. 1995 Mar;45(3 Pt 1):461-6
references.pmid: 7898697
references.citation: Acta Neuropathol. 1993;86(3):215-23
references.pmid: 8213079
references.citation: JAMA. 2011 Jan 19;305(3):275-83
references.pmid: 21245183
references.citation: Dement Geriatr Cogn Disord. 2007;23(5):316-20
references.pmid: 17374949
references.citation: Cereb Cortex. 1998 Sep;8(6):492-509
references.pmid: 9758213
references.citation: Alzheimers Dement. 2011 May;7(3):270-9
references.pmid: 21514249
references.citation: Arch Neurol. 1998 Jul;55(7):937-45
references.pmid: 9678311
references.citation: Lancet Neurol. 2007 Aug;6(8):734-46
references.pmid: 17616482
references.citation: Dement Geriatr Cogn Disord. 2003;16(3):170-80
references.pmid: 12826744
references.citation: Brain. 2007 Oct;130(Pt 10):2636-45
references.pmid: 17898010
references.citation: Arch Neurol. 1999 Mar;56(3):303-8
references.pmid: 10190820
references.citation: Arch Neurol. 1994 Jun;51(6):585-94
references.pmid: 8198470
references.citation: Neurology. 1991 Jul;41(7):1006-9
references.pmid: 2067629
references.citation: J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1085-90
references.pmid: 4078573
references.citation: Neurology. 1992 Mar;42(3 Pt 1):473-80
references.pmid: 1549205
references.citation: Arch Neurol. 2003 Oct;60(10):1385-9
references.pmid: 14568808
references.citation: J Neurol Sci. 1975 Sep;26(1):81-98
references.pmid: 1159460
references.citation: Neurology. 2003 Apr 22;60(8):1374-7
references.pmid: 12707450
references.citation: Neurology. 1993 Feb;43(2):250-60
references.pmid: 8094895
references.citation: J Neurosci. 2007 Jun 6;27(23):6174-84
references.pmid: 17553989
references.citation: J Am Geriatr Soc. 1995 Nov;43(11):1256-63
references.pmid: 7594160
references.citation: Int Psychogeriatr. 1994 Spring;6(1):63-8
references.pmid: 8054494
references.citation: Arch Neurol. 1999 Oct;56(10):1233-9
references.pmid: 10520939
references.citation: J Geriatr Psychiatry Neurol. 1991 Jan-Mar;4(1):26-9
references.pmid: 2054048
references.citation: J Neurol Neurosurg Psychiatry. 1998 Mar;64(3):298-305
references.pmid: 9527138
references.citation: BMJ. 1990 Nov 3;301(6759):1026
references.pmid: 2249050
references.citation: JAMA. 2001 Nov 7;286(17):2120-7
references.pmid: 11694153
references.citation: Arch Neurol. 2002 Jan;59(1):43-6
references.pmid: 11790229
references.citation: Neurology. 2000 Dec 26;55(12):1854-62
references.pmid: 11134385
references.citation: Neurology. 1989 Jan;39(1):76-9
references.pmid: 2642615
references.citation: Acta Neuropathol. 1987;74(3):209-25
references.pmid: 3673513
references.citation: Neurology. 2001 Jul 24;57(2):226-34
references.pmid: 11468306
references.citation: Neurobiol Aging. 2012 Jul;33(7):1203-14
references.pmid: 21159408
references.citation: Neurology. 1996 Mar;46(3):707-19
references.pmid: 8618671
references.citation: Neurology. 2006 Aug 8;67(3):446-52
references.pmid: 16894106
references.citation: Am J Psychiatry. 1995 Oct;152(10):1476-84
references.pmid: 7573587
references.citation: N Engl J Med. 1997 Dec 4;337(23):1667-74
references.pmid: 9385127
references.citation: Arch Neurol. 1994 Sep;51(9):888-95
references.pmid: 8080388
references.citation: Neurology. 1984 Jul;34(7):939-44
references.pmid: 6610841
references.citation: Neurology. 2006 Jun 27;66(12):1837-44
references.pmid: 16801647
references.citation: Neurology. 2004 Jul 13;63(1):115-21
references.pmid: 15249620
references.citation: Neurology. 1999 Apr 22;52(7):1397-403
references.pmid: 10227624
references.citation: Brain Cogn. 1996 Jul;31(2):176-87
references.pmid: 8811995
references.citation: Mov Disord. 2007 Sep 15;22(12):1689-707; quiz 1837
references.pmid: 17542011
references.citation: Lancet. 1997 Jun 21;349(9068):1793-6
references.pmid: 9269213
references.citation: Arch Neurol. 2007 Mar;64(3):416-20
references.pmid: 17353386
references.citation: J Am Geriatr Soc. 2004 Feb;52(2):195-204
references.pmid: 14728627
references.citation: Lancet. 2005 Dec 17;366(9503):2112-7
references.pmid: 16360788
references.citation: Arch Neurol. 1999 Nov;56(11):1368-73
references.pmid: 10555657
references.citation: Br J Psychiatry. 1999 Jan;174:45-50
references.pmid: 10211150
references.citation: Dement Geriatr Cogn Disord. 2000 Nov-Dec;11(6):342-9
references.pmid: 11044780
references.citation: J Intern Med. 2004 Sep;256(3):240-6
references.pmid: 15324367
references.citation: Can Med Assoc J. 1962 Feb 10;86:257-60
references.pmid: 14459267
references.citation: Neurology. 1990 Sep;40(9):1364-9
references.pmid: 2392219
references.citation: Alzheimers Dement. 2011 May;7(3):263-9
references.pmid: 21514250
references.citation: Acta Neuropathol. 1996;91(2):185-93
references.pmid: 8787153
references.citation: Acta Neurol Scand. 1982 Jun;65(6):636-50
references.pmid: 7113668
references.citation: Alzheimer Dis Assoc Disord. 1993 Fall;7(3):152-64
references.pmid: 8217089
references.citation: J Neurol Neurosurg Psychiatry. 1992 Dec;55(12):1177-81
references.pmid: 1479397
references.citation: Acta Neuropathol. 2009 Jul;118(1):37-52
references.pmid: 19306098
references.citation: Alzheimers Dement. 2011 May;7(3):280-92
references.pmid: 21514248
references.citation: Neurology. 1999 Oct 12;53(6):1292-9
references.pmid: 10522887
references.citation: Ann Neurol. 1988 Jul;24(1):50-6
references.pmid: 3415200
references.citation: J Int Neuropsychol Soc. 2005 Oct;11(6):708-15
references.pmid: 16248906
references.citation: Ann Neurol. 2004 Mar;55(3):306-19
references.pmid: 14991808