Perspectives on ethnic and racial disparities in Alzheimer&apos;s disease and related dementias: Update and areas of immediate need

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Abstract

Alzheimer's disease and related dementias (ADRDs) are a global crisis facing the aging population and society as a whole. With the numbers of people with ADRDs predicted to rise dramatically across the world, the scientific community can no longer neglect the need for research focusing on ADRDs among underrepresented ethnoracial diverse groups. The Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART; alz.org/ISTAART) comprises a number of professional interest areas (PIAs), each focusing on a major scientific area associated with ADRDs. We leverage the expertise of the existing international cadre of ISTAART scientists and experts to synthesize a cross-PIA white paper that provides both a concise "state-of-the-science" report of ethnoracial factors across PIA foci and updated recommendations to address immediate needs to advance ADRD science across ethnoracial populations.

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The diagnosis of dementia due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Guy M McKhann, David S. Knopman, Howard Chertkow … (2011)

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of revising the 1984 criteria for Alzheimer's disease (AD) dementia. The workgroup sought to ensure that the revised criteria would be flexible enough to be used by both general healthcare providers without access to neuropsychological testing, advanced imaging, and cerebrospinal fluid measures, and specialized investigators involved in research or in clinical trial studies who would have these tools available. We present criteria for all-cause dementia and for AD dementia. We retained the general framework of probable AD dementia from the 1984 criteria. On the basis of the past 27 years of experience, we made several changes in the clinical criteria for the diagnosis. We also retained the term possible AD dementia, but redefined it in a manner more focused than before. Biomarker evidence was also integrated into the diagnostic formulations for probable and possible AD dementia for use in research settings. The core clinical criteria for AD dementia will continue to be the cornerstone of the diagnosis in clinical practice, but biomarker evidence is expected to enhance the pathophysiological specificity of the diagnosis of AD dementia. Much work lies ahead for validating the biomarker diagnosis of AD dementia. Copyright © 2011. Published by Elsevier Inc.

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Dementia prevention, intervention, and care

Gill Livingston, Andrew Sommerlad, Vasiliki Orgeta … (2018)

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Bruno Dubois, Howard H. Feldman, Claudia Jacova … (2014)

In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Author and article information

Journal

Title: Alzheimer's & Dementia

Abbreviated Title: Alzheimer's & Dementia

Publisher: Elsevier BV

ISSN (Print): 1552-5260

ISSN (Electronic): 1552-5279

Publication date Created: February 2019

Publication date (Electronic): December 13 2018

Publication date (Print): February 2019

Volume: 15

Issue: 2

Pages: 292-312

Affiliations

[1 ]Department of Neurology and Knight Alzheimer's Disease Research CenterWashington University School of MedicineSt. LouisMOUSA

[2 ]Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

[3 ]Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

[4 ]Division of Neurodegenerative DisordersSt. Boniface Hospital Albrechtsen Research CentreWinnipegManitobaCanada

[5 ]Department of Pharmacology & TherapeuticsUniversity of ManitobaWinnipegManitobaCanada

[6 ]Department of RadiologyMayo ClinicRochesterMNUSA

[7 ]Department of Occupational Sciences & Occupational TherapyUniversity of TorontoCA

[8 ]School of Psychology and Clinical Language SciencesUniversity of ReadingUK

[9 ]Department of Physiology and Pharmacology “V. Erspamer”Sapienza University of RomeRomeItaly

[10 ]Department of NeuroscienceIRCCS‐Hospital San Raffaele Pisana of Rome and CassinoRome and CassinoItaly

[11 ]Academic Unit for Psychiatry of Old AgeDepartment of PsychiatryUniversity of MelbourneAustralia

[12 ]Syneos HealthWilmingtonNCUSA

[13 ]Nutrition and Brain Health LaboratoryNestlé Institute of Health SciencesLausanneSwitzerland

[14 ]Department of NeurologyLayton Aging & Alzheimer's Disease CenterOregon Health & Science UniversityPortlandORUSA

[15 ]Taub Institute for Research in Alzheimer's Disease and the Aging BrainThe Gertrude H. Sergievsky CenterDepartment of NeurologyColumbia UniversityNew YorkNYUSA

[16 ]Inserm, Inserm UMR‐S U1237Université de Caen‐NormandieGIP CyceronCaenFrance

[17 ]Department of Occupational Therapy EducationUniversity of Kansas Medical CenterKansas CityKSUSA

[18 ]Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPAUSA

[19 ]Gillings School of Global Public HealthUniversity of North CarolinaChapel HillNCUSA

[20 ]Department of NeurologyLayton Aging and Alzheimer's Disease CenterOregon Health & Science UniversityPortland, OR, USA

[21 ]Undergraduate Program of History and ScienceHarvard CollegeCambridgeMAUSA

[22 ]Department of Family Medicine and Public HealthUniversity of CaliforniaSan DiegoCAUSA

[23 ]Department of PediatricsUniversity of Cincinnati College of Medicine & Division of Developmental and Behavioral PediatricsCincinnati Children's Hospital Medical CenterCincinnatiOHUSA

[24 ]Melbourne Medical SchoolUniversity of MelbourneAustralia

[25 ]Institute for Stroke and Dementia ResearchKlinikum der Universität MünchenMunichGermany

[26 ]Medical & Scientific RelationsAlzheimer's AssociationChicagoILUSA

[27 ]Memory UnitDepartment of NeurologyHospital de la Santa Creu i Sant PauBiomedical Research Institute Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain

[28 ]Barcelona Down Medical CenterFundació Catalana de Síndrome de DownBarcelonaSpain

[29 ]Department of Neurosciences and Shiley‐Marcos Alzheimer's Disease Research CenterUniversity of San DiegoCAUSA

[30 ]Department of NeurologySection for NeuroEpidemiologyState University of New York – Downstate Medical CenterBrooklynNYUSA

[31 ]Sanders Brown Center on AgingUniversity of KentuckyLexingtonKYUSA

[32 ]Adult Development and AgingUniversity of VictoriaBritish ColumbiaCAUSA

[33 ]Department of Pharmacology & NeuroscienceUniversity of North Texas Health Science CenterFort WorthTXUSA

[34 ]VU University Medical CenterDepartment of NeurologyAmsterdam NeuroscienceAmsterdamthe Netherlands

[35 ]Department of PsychologyUniversity of GlasgowGlasgowScotlandUK

[36 ]Sunnybrook Research Institute of Psychiatry and PharmacologyUniversity of TorontoTorontoONCanada

[37 ]Aging and Alzheimer's DiseaseSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupAustralia

[38 ]Department of EpidemiologyMayo ClinicRochesterMNUSA

[39 ]Department of NeurologyMayo ClinicRochesterMNUSA

[40 ]Department of Internal MedicineRush UniversityChicagoILUSA

[41 ]Department of NeuroscienceMayo ClinicJacksonvilleFLUSA

[42 ]Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA

[43 ]School of Social SciencesDepartment of PsychologyHeriot‐Watt UniversityUK

[44 ]Universidad Autónoma del CaribeBarranquillaColombia

[45 ]Neuroprogressive and Dementia NetworkUK

[46 ]Department of NeurosciencesUniversity of California San Diego School of MedicineCAUSA

[47 ]Department of Psychiatry and PsychologyMayo ClinicJacksonvilleFLUSA

[48 ]Aiginition Hospital1st Neurology ClinicDepartment of Social Medicine, Psychiatry and NeurologyNational and Kapodistrian University of AthensAthensGreece

[49 ]Department of Psychiatry and The Behavioral SciencesUniversity of Southern CaliforniaCAUSA

[50 ]Department of EpidemiologyMailman School of Public Health Columbia UniversityNew YorkNYUSA

[51 ]Massachusetts General HospitalDepartment of NeurologyBostonMAUSA

[52 ]Department of NeurologyColumbia UniversityNew YorkNYUSA

[53 ]Department of PsychiatryColumbia UniversityNew YorkNYUSA

[54 ]Department of Forensic and Neurodevelopmental ScienceInstitute of Psychiatry Psychology and NeuroscienceKing's College LondonLondonUK

[55 ]Department of NeurologyXuan Wu HospitalCapital Medical UniversityBeijingChina

[56 ]Centers for Clinical Brain Sciences and Dementia PreventionUniversity in EdinburghScotlandUK

[57 ]Neurochemistry Laboratory and BiobankDepartment of Clinical ChemistryAmsterdam NeuroscienceVrije Universiteit University Medical CenterAmsterdamthe Netherlands

[58 ]Department of Clinical ResearchGerman Center for Neurodegenerative Diseases (DZNE)BonnGermany

[59 ]Vrije Universiteit AmsterdamAmsterdamthe Netherlands

[60 ]UK Dementia Research Institute at UCLLondonUK

[61 ]Department of Molecular NeuroscienceUCL Institute of NeurologyQueen SquareLondonUK

[62 ]Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden

[63 ]Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska Academy at the University of GothenburgMölndalSweden