For the first time in 27 years, researchers have published new criteria for the diagnosis of disease Alzheimer. With tests to pick up not ready for widespread use of the early stages of the disease, the new guidelines will have little immediate impact on patients, but they are intended to provide a framework for research and planning, hopefully clinicians the day the effective treatments become available.
guidelines, issued today by the Alzheimer's Association and the National Institute on Aging (NIA) and published online in of Alzheimer's disease and dementia reflect the growing understanding that the neurological damage of Alzheimer's disease starts years, even decades, before symptoms appear and future treatments probably work best when started early. They broaden the definition of Alzheimer's to include two new stages that precede dementia in their own right: a presymptomatic phase and a phase marked by mild cognitive impairment.
The new guidelines are the revised recommendations made last year.
At a press conference yesterday, Creighton Phelps NIA explained that a major revision was to clarify what recommendations relate to researchers and which relate to clinicians. In particular, the expert working groups that drafted the guidelines say that biomarker tests for Alzheimer's disease, which capture biological early signs of the disease are not yet ready for widespread clinical use. (Because the newly proposed presymptomatic stage of the disease can be detected by biomarker tests, this designation may be used by researchers at this time.)
In recent years, researchers have made considerable progress on biomarkers, including scans that detect changes in brain anatomy and physiology and tests that measure the levels of β-amyloid peptide thought to be a significant player in the disease in the brain and cerebrospinal fluid. These tests can pick up signs of Alzheimer's disease in people before memory problems appear, and they are already used in clinical trials. Many researchers believe that so many clinical trials, due to potential Alzheimer's treatments have failed in recent years is that the patients included in the trials were too far in the course of the disease. Biomarkers that can pick up early signs of the disease may enable doctors to begin treatment before too much irreversible brain damage has occurred. For now, it is only in clinical trials.
The working groups concluded that although the biomarkers are invaluable for research, more work is needed before it can be widely used by physicians. For example, the methods should be standardized so that they are used consistently from one hospital to another, and researchers need to reach a consensus on values delimit the boundary between health and disease.
0 Komentar