The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease

Abstract

The National Institute on Aging and the Alzheimer's Association charged a workgroup with the task of developing criteria for the symptomatic predementia phase of Alzheimer's disease (AD), referred to in this article as mild cognitive impairment due to AD. The workgroup developed the following two sets of criteria: (1) core clinical criteria that could be used by healthcare providers without access to advanced imaging techniques or cerebrospinal fluid analysis, and (2) research criteria that could be used in clinical research settings, including clinical trials. The second set of criteria incorporate the use of biomarkers based on imaging and cerebrospinal fluid measures. The final set of criteria for mild cognitive impairment due to AD has four levels of certainty, depending on the presence and nature of the biomarker findings. Considerable work is needed to validate the criteria that use biomarkers and to standardize biomarker analysis for use in community settings.

Conflict of interest statement

With regard to potential conflicts of interest, Marilyn Albert serves as a consultant to Genentech and Eli Lilly and receives grants to her institution from GE Healthcare. Steven DeKosky serves as a consultant to Eisai, Merck, Elan/Wyeth, Novartis, he serves on the advisory board of Pfizer and provides clinical services to United Healthcare. Dennis Dickson report no conflicts. Bruno Dubois serves as a consultant to Affiris, Pierre Fabre, and Eisai, serving on a scientific advisory board for Bristol-Meyers Squibb, Roche, Pfizer, Eli Lilly, and GE Healthcare, and receives grants to his institution from Novartis, Roche, and Eisai. Howard Feldman is an employee of Bristol Meyers Squibb (BMS) and holds stock in BMS; he serves as a consultant to Servier, Glia Scientific, and Pfizer, and serves on a scientific advisory board for Elan, Janssen, Canada, and Wyeth. Nick Fox serves as a consultant (payment to Institute of Neurology) for BMS, Elan/Janssen, Eli Lilly, GE, Lundbeck, and Pfizer/Wyeth. The Institute of Neurology (Nick Fox) has conducted image analysis for Elan/Janssen, Lundbeck, and Pfizer/Wyeth. Anthony Gamst reports no conflicts. David Holtzman serves as a consultant for Bristol-Myers Squibb, Pfizer, and Innogenetics; he serves on a scientific advisory board for En Vivo, Satori, and C2N Diagnostics; and receives grants to his institution from Pfizer, Eli Lilly, and Astra Zeneca. William Jagust serves as a consultant to Genentech, Bayer Healthcare, GE Healthcare. Synarc, Otsuka Pharmaceuticals, Janssen Alzheimer Immunotherapy, Merck, and Tau Rx. Ronald Petersen serves as a consultant for Elan Pharmaceuticals and GE Healthcare and serves on data monitoring committees for Pfizer, Inc., Janssen Alzheimer Immunotherapy. Peter Snyder serves as a consultant to CogState Ltd. Maria Carrillo is an employee of the Alzheimer’s Association and reports no conflicts. Bill Thies is an employee of the Alzheimer’s Association and reports no conflicts. Creighton Phelps is an employee of the U.S. Government and reports no conflicts.

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