Very early detection of Alzheimer neuropathology and the role of brain reserve in modifying its clinical expression

被引:139
作者
Mortimer, JA [1 ]
Borenstein, AR
Gosche, KM
Snowdon, DA
机构
[1] Univ S Florida, Coll Publ Hlth, Dept Epidemiol & Biostat, Tampa, FL 33612 USA
[2] NeuroImaging Res, Alachua, FL USA
[3] Univ Kentucky, Dept Neurol, Sanders Brown Ctr Aging, Lexington, KY USA
关键词
Alzheimer's disease; biomarkers; prevention;
D O I
10.1177/0891988705281869
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Numerous studies show that the pathology of Alzheimer's disease is present decades before a clinical diagnosis of dementia can be made. Given the likelihood that agents will become available that reliably delay onset and/or slow progression of Alzheimer's disease, it will be important to detect preclinical Alzheimer's disease as early as possible for maximal treatment effect. Detection of individuals by sensitive cognitive measures provides one way to identify people who are at high risk of developing clinical Alzheimer's disease. However, it is likely that those with considerable brain or cognitive reserve will be able to mask cognitive deficits until very close to the onset of the dementia, rendering such cognitive measures insensitive. Optimum biomarkers for Alzheimer's disease therefore need to target the severity of underlying brain pathology independently of brain reserve. Findings are presented showing the importance of higher education and larger brain size in masking the underlying disease pathology.
引用
收藏
页码:218 / 223
页数:6
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