Revision of Alzheimer’s diagnostic criteria or relocation of the Potemkin village
Year: 2023
Type: article
Abstract: The recently announced revision of the Alzheimer's disease (AD) diagnostic ATN classification adds to an already existing disregard for clinical assessment the rejection of image-based in vivo assessment of the brain's condition. The revision suggests that the diagnosis of AD should be based solely on the presence of cerebral amyloid-beta and tau, indicated by the "A" and "T". The "N", which stands for neurodegeneration - detected by imaging - should no longer be given importance, except that A+ ± T + = AD with amyloid PET being the main method for demonstrating A+ . We believe this is an artificial and misleading suggestion. It is artificial because it relies on biomarkers whose significance remains obscure and where the detection of "A" is based on a never-validated PET method using a tracer that marks much more than amyloid-beta. It is misleading because many patients without dementia will be falsely classified as having AD, but nonetheless candidates for passive immunotherapy, which may be more harmful than beneficial, and sometimes fatal.
Source: Ageing Research Reviews
Institutions: University of Southern Denmark, Odense University Hospital, Hospital of the University of Pennsylvania, University of California, Los Angeles, Northwestern University, Ospedale Koelliker, University of Turin, University of Pittsburgh, Technical University of Denmark, Massachusetts General Hospital, The University of Texas at San Antonio, Oslo University Hospital, University of Oslo, Icahn School of Medicine at Mount Sinai, University of Chieti-Pescara, UNSW Sydney, St Vincent's Hospital Sydney
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,820
OpenAlex ID: W4389817626