Appearance
Alzheimer's disease.
Literature Information
| DOI | 10.1016/S0140-6736(10)61349-9 |
|---|---|
| PMID | 21371747 |
| Journal | Lancet (London, England) |
| Publication Year | 2011 |
| Times Cited | 984 |
| Keywords | Alzheimer's disease, pathogenesis, diagnosis, treatment, risk factors |
| Literature Type | Journal Article, Research Support, Non-U.S. Gov't, Review |
| ISSN | 0140-6736 |
| Pages | 1019-31 |
| Issue | 377(9770) |
| Authors | Clive Ballard, Serge Gauthier, Anne Corbett, Carol Brayne, Dag Aarsland, Emma Jones |
TL;DR
This seminar reviews recent findings on Alzheimer's disease, highlighting its significant public health impact due to the estimated 24 million affected individuals globally and the urgent need for improved understanding of its pathogenesis and biomarkers for diagnosis. The study emphasizes the importance of identifying risk and protective factors to develop effective interventions that could potentially reduce the incidence of dementia and cognitive decline.
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Alzheimer's disease · pathogenesis · diagnosis · treatment · risk factors
Abstract
An estimated 24 million people worldwide have dementia, the majority of whom are thought to have Alzheimer's disease. Thus, Alzheimer's disease represents a major public health concern and has been identified as a research priority. Although there are licensed treatments that can alleviate symptoms of Alzheimer's disease, there is a pressing need to improve our understanding of pathogenesis to enable development of disease-modifying treatments. Methods for improving diagnosis are also moving forward, but a better consensus is needed for development of a panel of biological and neuroimaging biomarkers that support clinical diagnosis. There is now strong evidence of potential risk and protective factors for Alzheimer's disease, dementia, and cognitive decline, but further work is needed to understand these better and to establish whether interventions can substantially lower these risks. In this Seminar, we provide an overview of recent evidence regarding the epidemiology, pathogenesis, diagnosis, and treatment of Alzheimer's disease, and discuss potential ways to reduce the risk of developing the disease.
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Primary Questions Addressed
- What are the latest findings on the interaction between lifestyle factors and Alzheimer's disease progression?
- How do emerging biomarkers like amyloid β oligomers and synaptic markers compare to traditional biomarkers in terms of diagnostic accuracy?
- What role does tau PET imaging play in the early diagnosis and differentiation of Alzheimer's disease from other types of dementia?
- How might the concept of preclinical Alzheimer's disease change the approach to early intervention and treatment strategies?
- What are the implications of combining anti-Alzheimer's therapies with lifestyle interventions for long-term patient outcomes?
Key Findings
Research Background and Objectives
Alzheimer's disease (AD) affects approximately 24 million individuals globally, predominantly contributing to the dementia burden. This condition is a significant public health issue, necessitating urgent research to deepen our understanding of its pathogenesis and to facilitate the development of disease-modifying therapies. The study aims to provide a comprehensive overview of recent findings related to the epidemiology, pathogenesis, diagnosis, and treatment of Alzheimer's disease, while also exploring potential strategies to mitigate the risk of developing the disease.
Main Methods/Materials/Experimental Design
The research utilizes a systematic review approach to gather and synthesize current evidence on Alzheimer's disease. Key areas of focus include:
- Epidemiology: Analysis of prevalence and risk factors.
- Pathogenesis: Exploration of biological mechanisms underlying AD.
- Diagnosis: Assessment of current diagnostic methods and the need for biomarker panels.
- Treatment: Evaluation of existing therapeutic options and their limitations.
The following flowchart illustrates the methodological framework:
Key Results and Findings
- Epidemiology: Strong evidence identifies both risk and protective factors associated with Alzheimer's disease and cognitive decline.
- Pathogenesis: The review highlights the complex biological processes involved in AD, including amyloid-beta accumulation and tau pathology.
- Diagnosis: There is a consensus on the need for a comprehensive panel of biological and neuroimaging biomarkers to enhance diagnostic accuracy.
- Treatment: While existing treatments can alleviate symptoms, there is a critical need for interventions that modify disease progression.
Main Conclusions/Significance/Innovation
The seminar underscores the urgency of advancing our understanding of Alzheimer's disease to facilitate the development of effective interventions. It emphasizes the importance of a multi-faceted approach combining epidemiological insights, biological research, and clinical practices. The proposed strategies for risk reduction may have significant implications for public health and the management of Alzheimer's disease.
Research Limitations and Future Directions
- Limitations: The review is constrained by the variability in study designs and methodologies of the included research, which may affect the generalizability of findings.
- Future Directions: Further research is essential to:
- Establish a standardized panel of biomarkers for early diagnosis.
- Investigate the efficacy of lifestyle interventions in reducing Alzheimer's disease risk.
- Explore novel therapeutic targets that could lead to disease-modifying treatments.
This comprehensive overview provides a foundation for ongoing research and highlights the critical need for collaborative efforts in tackling the challenges posed by Alzheimer's disease.
Literatures Citing This Work
- Untapped ethical resources for neurodegeneration research. - Julie M Robillard;Carole A Federico;Kate Tairyan;Adrian J Ivinson;Judy Illes - BMC medical ethics (2011)
- Biomarkers in Alzheimer's disease. - Mario Riverol;Oscar L López - Frontiers in neurology (2011)
- Berberine: a potential multipotent natural product to combat Alzheimer's disease. - Hong-Fang Ji;Liang Shen - Molecules (Basel, Switzerland) (2011)
- Dementia and Alzheimer's disease: a new direction.The 2010 Jay L. Foster Memorial Lecture. - Lewis H Kuller;Oscar L Lopez - Alzheimer's & dementia : the journal of the Alzheimer's Association (2011)
- Brain microvasculature and hypoxia-related proteins in Alzheimer's disease. - Paula Grammas;Debjani Tripathy;Alma Sanchez;Xiangling Yin;Jinhua Luo - International journal of clinical and experimental pathology (2011)
- Assessing the sociocultural impacts of emerging molecular technologies for the early diagnosis of Alzheimer's disease. - Marianne Boenink;Yvonne Cuijpers;Anna Laura van der Laan;Harro van Lente;Ellen Moors - International journal of Alzheimer's disease (2011)
- Interactions of AChE with Aβ Aggregates in Alzheimer's Brain: Therapeutic Relevance of IDN 5706. - Francisco J Carvajal;Nibaldo C Inestrosa - Frontiers in molecular neuroscience (2011)
- Next-generation DNA sequencing-based assay for measuring allelic expression imbalance (AEI) of candidate neuropsychiatric disorder genes in human brain. - Xiang Xu;Hao Wang;Min Zhu;Yue Sun;Yu Tao;Qin He;Jian Wang;Li Chen;David Saffen - BMC genomics (2011)
- Alzheimer's disease--input of vitamin D with mEmantine assay (AD-IDEA trial): study protocol for a randomized controlled trial. - Cédric Annweiler;Bruno Fantino;Elsa Parot-Schinkel;Samuel Thiery;Jennifer Gautier;Olivier Beauchet - Trials (2011)
- Convergent pathogenic pathways in Alzheimer's and Huntington's diseases: shared targets for drug development. - Dagmar E Ehrnhoefer;Bibiana K Y Wong;Michael R Hayden - Nature reviews. Drug discovery (2011)
... (974 more literatures)
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