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Biomarkers in the Diagnosis of Alzheimer’s Disease: Are We Ready?

Geriatric Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland, trey{at}mail.nih.gov

Harald Hampel, MD

Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany

Masatoshi Takeda, MD, PhD

Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan

Karen T. Putnam, MS

Litwin-Zucker Research Center, North Shore-LIJ Health System, Great Neck, New York

Robert M. Cohen, MD, PhD

Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, California

Although clinical manifestations of cognitive dysfunction and impairments of activities of daily living are the current standard measures for the diagnosis of Alzheimer’s disease, biomarkers are receiving increasing attention in research centers as possible early diagnostic measures or as surrogate measures of the ongoing pathology. In preparation for the upcoming development of the Diagnostic and Statistical Manual of Mental Disorders (5th ed; DSM-V) nosology, the American Psychiatric Association has sponsored an effort to reassess the current approaches to diagnosis in dementia in general and Alzheimer’s disease in particular. This article focuses on the potential use of biomarkers in the diagnosis of Alzheimer’s disease, in the monitoring of mild cognitive impairment, and as possible prognostic markers in normal controls at risk for dementia. Most advanced information is available with the biomarkers found in the cerebrospinal fluid, but there are many other potential biomarkers using blood, brain imaging, or a combination. The current biomarker approaches to diagnosis are reviewed along with a special emphasis on near-term recommendations and further research directions. (J Geriatr Psychiatry Neurol 2006;19:172-179)

Key Words: biomarkers • Alzheimer’s disease • cerebrospinal fluid • sensitivity and specificity • diagnosis

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