Cited by 652Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCancer-related cognitive impairment studies

Alzheimer’s Disease: Epidemiology and Clinical Progression

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Tahami Monfared, Amir Abbas, Byrnes, Michael J., White, Leigh Ann, Zhang, Quanwu·2022·Neurology and Therapy

Abstract

Alzheimer's disease (AD) is prevalent throughout the world and is the leading cause of dementia in older individuals (aged ≥ 65 years). To gain a deeper understanding of the recent literature on the epidemiology of AD and its progression, we conducted a review of the PubMed-indexed literature (2014-2021) in North America, Europe, and Asia. The worldwide toll of AD is evidenced by rising prevalence, incidence, and mortality due to AD-estimates which are low because of underdiagnosis of AD. Mild cognitive impairment (MCI) due to AD can ultimately progress to AD dementia; estimates of AD dementia etiology among patients with MCI range from 40% to 75% depending on the populations studied and whether the MCI diagnosis was made clinically or in combination with biomarkers. The risk of AD dementia increases with progression from normal cognition with no amyloid-beta (Aβ) accumulation to early neurodegeneration and subsequently to MCI. For patients with Aβ accumulation and neurodegeneration, lifetime risk of AD dementia has been estimated to be 41.9% among women and 33.6% among men. Data on progression from preclinical AD to MCI are sparse, but an analysis of progression across the three preclinical National Institute on Aging and Alzheimer's Association (NIA-AA) stages suggests that NIA-AA stage 3 (subtle cognitive decline with AD biomarker positivity) could be useful in combination with other tools for treatment decision-making. Factors shown to increase risk include lower Mini-Mental State Examination (MMSE) score, higher Alzheimer's Disease Assessment Scale (ADAS-cog) score, positive APOE4 status, white matter hyperintensities volume, entorhinal cortex atrophy, cerebrospinal fluid (CSF) total tau, CSF neurogranin levels, dependency in instrumental activities of daily living (IADL), and being female. Results suggest that use of biomarkers alongside neurocognitive tests will become an important part of clinical practice as new disease-modifying therapies are introduced.

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  • CNS diseases include neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease, as well as traumatic brain injuries and spinal cord injuries.

    “The diseases encompass various severe conditions, including neurodegenerative disorders like Alzheimer’s disease (AD) [3, 4] and Parkinson’s disease (PD) [5, 6], as well as traumatic brain injuries (TBI) [7] and spinal cord injuries (SCI) [8].”

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Authors
Tahami Monfared, A. A., Byrnes, M. J., White, L. A., & Zhang, Q.
Affiliations
Eisai (United States) (US)
Venue
Neurology and Therapy
Published
2022-03-14
Volume
11
Issue
2
Pages
553-569
ISSN
  • 2193-6536 (ISSN-L)
  • 2193-8253
OpenAlex
W4221041873
Cited by
629
References
74
Citations by year
2026: 161 · 2025: 208 · 2024: 161 · 2023: 80 · 2022: 19
FWCI
20.14
Type
journal article
Language
en
Open access
Locations
  • Neurology and Therapy (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Funders
Eisai
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
Keywords
Alzheimer's disease, clinical progression, mild cognitive impairment, amyloid-beta deposition, neurodegeneration, preclinical Alzheimer's disease, disease risk factors, APOE ε4, white matter hyperintensities, entorhinal cortex atrophy, cerebrospinal fluid biomarkers, tau protein, neurogranin, dementia mortality, underdiagnosis, disease-modifying therapy

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