Biomarkers and the diagnosis of preclinical dementia

Alzheimer's disease pathology accumulates years before the onset of clinical symptoms and has been termed ‘preclinical dementia’. Biomarkers have been developed to detect this pathology – namely, brain amyloid deposition and markers of neurodegeneration. In this article we describe these biomar...

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Bibliographic Details
Published in:BJPsych advances 2018-11, Vol.24 (6), p.422-430
Main Authors: Lilford, Philippa, Hughes, Julian C.
Format: Article
Language:English
Subjects:
Activities of daily living
Alzheimer's disease
Biomarkers
Cognitive ability
Dementia
Medical imaging
Memory
Neurodegeneration
Pathology
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Summary:Alzheimer's disease pathology accumulates years before the onset of clinical symptoms and has been termed ‘preclinical dementia’. Biomarkers have been developed to detect this pathology – namely, brain amyloid deposition and markers of neurodegeneration. In this article we describe these biomarkers and review the evidence for their clinical use in predicting risk both in the cognitively ‘normal’ and in those who already have established cognitive decline. We also discuss the limitations and ethical considerations of these tests and consider whether we should start incorporating Alzheimer's disease biomarkers into clinical practice. We find that, because many cognitively healthy people will have Alzheimer's pathology, and it is not clear whether this does help predict future risk of Alzheimer's disease, diagnosing preclinical dementia carries numerous ethical implications and is currently not being advocated outside research settings.
ISSN:2056-4678
2056-4686
DOI:10.1192/bja.2018.28