![Page 1: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/1.jpg)
Toward to a pre-Toward to a pre-symptomatic diagnosis symptomatic diagnosis
of Alzheimer’sof Alzheimer’s
Marcos Díaz Díaz
Salamanca 2013
![Page 2: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/2.jpg)
Index Alzheimer’s Disease
Epidemiology and costs
Limitations of diagnosis criteria
Neuroimaging
Biomarkers
Current treatment for AE
Redefinition of disease
![Page 3: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/3.jpg)
Alheimer’s Disease Neurodegenerative disease
Unknown etiology
Etiopathogenic puzzle
Neurofibrillary tangles
Neuritic plaques (APP)
“Amyloid cascade”
ApoE
![Page 4: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/4.jpg)
Epidemiology & costs 2010: more than half a million in Spain 2050: 1.5 million in Spain 2050: 115 million in the world WHO: 215 thousand million €/year in dementia Spain: 24.000€ / Europe: 54.000€ 286h/month – 70h/week Studies-researches:
Winsconsin United Biosource
![Page 5: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/5.jpg)
Limitations of diagnosis criteria
Screening tests in primary attention
DSM-IV
CIE-10
Mild cognitive impairment –MCI-
Cognitive reserve theory
Too late
![Page 6: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/6.jpg)
Neuroimaging Computerized Tomography (CT)
Magnetic Resonance Imaging (MRI)
Single-Photon Emission Computed Tomography (SPECT)
Positron Emission Tomography (PET) FDG
FDDNP
PIB
F-BAY94-9172
Florbetapir-F-18
![Page 7: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/7.jpg)
Biomarkers Genetic biomarkers
CSF biomarkers
-amiloide peptideβ
Tau protein T-tau
P-tau
-amiloide & tau proteins combinedβ
-amiloide & tau proteins in MCIβ
Concomitant use of different biomarkers
![Page 8: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/8.jpg)
Biomarkers
![Page 9: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/9.jpg)
Current treatment for AE Non-pharmacological therapy & concomitant therapy AchE-Inhibitors & memantine Monoclonal antibody (mab)
Bapineuzumab Scarlet Road Study
Gantenerumab Washington University Study
Gantenerumab Solanezumab LY2886721
![Page 10: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/10.jpg)
Redefinition of disease
Clinical-biological model:
Alzheimer’s Disease
Alzheimer’s Dementia
Dubois criteriaDubois criteriaMCI or episodic memory debts for more than 6 months
+
CSF (P-tau o A42)βor
MRI (entorhinal atrophy/amygdala)
or
PET (bilateral temporal hypometabolism or PET-PIB)
or
ApoE (4-4)
![Page 11: Toward to a pre-symptomatic diagnosis of Alzheimer's](https://reader034.vdocuments.us/reader034/viewer/2022052619/55626413d8b42ae87d8b4f30/html5/thumbnails/11.jpg)
Toward to a pre-Toward to a pre-symptomatic diagnosis symptomatic diagnosis
of Alzheimer’sof Alzheimer’s
Marcos Díaz Diaz
Salamanca 2013