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Advisory Council April 2016 Meeting Presentation: Terminology Heterogeneity

Friday, April 29, 2016

Terminology Heterogeneity

Ronald C. Petersen, PhD, MD
Mayo Clinic

Dementia

Pie Chart: Alzheimer's Disease (53%), AD vascular dementia (10%), Vascular dementia (8%), Frontotemporal dementia (8%), Other (6%), DLB (5%), AD+ dementia with DLB (10%).

Multiple Terminologies

AD spectrum
ADRD
- FTD
- DLB
- VCID
DSM-5
Dementia
MCI
Prodromal

Old Conception of Alzheimer’s Disease

Brain wave diagram: Cognitively Normal - Dementia.

Cognitive Continuum

Brain wave diagrams: Normal, MCI, and Dementia.

Alzheimer’s Disease Spectrum

Brain wave diagrams: Preclinical AD, MCI Due to AD, and Dementia Due to AD.

Alzheimer’s Disease Spectrum

Brain wave diagrams: Asymptomatic (Preclinical AD) - Symptomatic (MCI Due to AD and Dementia Due to AD).

Evolution of MCI Criteria Including Prodromal AD

Timelines: 1979 - 2013, 2007 - 2013.

Petersen, Continuum, in press

Diagram

Clinical Spectrum CN - MCI - Dementia [Clinical]
- Aß [Pathology]
- TAU [Pathology]
- Other [Pathology]
- Vascular Disease [Pathology]
- Alpha Synuclein [Pathology]
- TDP-43 [Pathology]

Diagram

Clinical Spectrum CN - MCI - Dementia [Clinical]
- Aß [Pathology]
  - PET/CSF [Biomarker]
    - Rx? [Therapy]
- TAU [Pathology]
  - PET/CSF [Biomarker]
    - Rx? [Therapy]
- Other [Pathology]
  - ? [Biomarker]
    - Rx? [Therapy]
- Vascular Disease [Pathology]
  - MRI [Biomarker]
    - Rx? [Therapy]
- Alpha Synuclein [Pathology]
  - CSF? [Biomarker]
    - Rx? [Therapy]
- TDP-43 [Pathology]
  - CSF? [Biomarker]
    - Rx? [Therapy]

Introduction to the Recommendations from the National Institute onAging-Alzheimer’s Association Workgroups on Diagnostic Guidelinesfor Alzheimer’s Disease

Clifford R. Jack, Jr, Marilyn S. Albert, David S. Knopman,Guy M. McKhann, Reisa A. Sperling, Maria C. Carrillo,Bill Thies, Creighton H. Phelps

Alz and Dementia, 2011

DSM 5

Mild Neurocognitive Disorder (MCI)	Major Neurocognitive Disorder (Dementia)
Cognition Independence
Cognitive decline Single cognitive domain impaired (usually) Preservation of independence	Cognitive decline Significant cognitive impairment in one or more often multiple cognitive domains Loss of independence

Mild Cognitive Impairment

Flow chart.

Petersen et al., J Int Med, 2013

Alzheimer’s Disease Spectrum

Brain wave diagrams: Preclinical AD, MCI Due to AD, and Dementia Due to AD.

Files

Mtg20-Slides1.pdf (pdf, 992.69 KB)