Is Alzheimer’s disease still a diagnosis of exclusion, or are there now reliable signs?

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Is Alzheimer’s disease still a diagnosis of exclusion, or are there now reliable signs?

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Alzheimer’s disease has never really been just a diagnosis of exclusion because a certain clinical picture must be established first, before the other systemic and brain disorders are ruled out. The patient must have an episodic memory disorder with at least one second domain of cognitive impairment (attention, language, visuo-perceptive ability, frontal-executive ability, praxis). The disorder must represent a change from baseline and must be progressive (McKhann G et al. Neurology. 1984;34:939-944). For research purposes, it may now be possible to identify some AD patients early, relying more on the basis of testing parameters (Dubois B et al. Lancet. 2007p6(8):734-746). The patient must still have an episodic memory disorder, supported by neuroimaging findings (hippocampal atrophy or parieto-temporal hypometabolism on FDG-PET) and/or CSF biomarkers (low abeta and/or elevated tau protein). These criteria are fairly specific for the presence of AD, but they are not sensitive enough fo

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NedBarton

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