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

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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

DOI 10.1007/s40120-022-00338-8PMC PMC9095793

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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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Authors: Tahami Monfared, A. A., Byrnes, M. J., White, L. A., & Zhang, Q.
Affiliations: Eisai (United States) (US)
ORCID: Byrnes, Michael J.
Zhang, Quanwu
Venue: Neurology and Therapy
Publisher: Springer Science and Business Media LLC
Published: 2022-03-14
Volume: 11
Issue: 2
Pages: 553-569
ISSN: 2193-6536 (ISSN-L)
2193-8253
DOI: 10.1007/s40120-022-00338-8
PMC: PMC9095793
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: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/4.0 (tdm)
creativecommons.org/licenses/by-nc/4.0 (vor)
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
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
Health Sciences › Medicine › Oncology › 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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