Pieter Jelle Visser

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Pieter Jelle Visser

  1. 1. Comparison of International Working Group and NIA-AA criteria for Alzheimer’s disease Pieter Jelle Visser, MD, PhD Alzheimer centre, MeHNS, Department of Psychiatry, University of Maastricht Maastricht Alzheimer center, Department of Neurology, VUMC, Amsterdam The Netherlands
  2. 2. IWG versus NIA-AA• Approach• Terminology• Cognitive criteria• Biomarker criteria• Challenges ahead
  3. 3. Approach IWG NIA-AA Normal Normal ADAD MCI MCI AD Dementia Dementia AD
  4. 4. TerminologyAsymptomatic stage Symptomatic stage AD-SCI AD-MCI stage AD-dementia stage stage Visser et al in preparation
  5. 5. Terminology Asymptomatic stage Symptomatic stage AD-SCI AD-MCI stage AD-dementia stage stage Asymptomatic at risk ? Prodromal AD AD dementiaIWG for AD AD (typical/atypical)
  6. 6. Terminology Asymptomatic stage Symptomatic stage AD-SCI AD-MCI stage AD-dementia stage stage Asymptomatic at risk ? Prodromal AD AD dementia IWG for AD AD (typical/atypical) Preclinical AD MCI due to AD Dementia due toNIA-AA Stages 1-2 Stage 3 AD
  7. 7. Cognitive criteria IWG NIA-AA Memory - MCICognition Cognition impairment - Dementia
  8. 8. Biomarker criteria NIA-AA Amyloid Injury CSF Abeta 42 Tau, p-tau sMRI - Hippocampal atrophyIWG PET Amyloid FDG - SPECT
  9. 9. Biomarker criteria NIA-AA Amyloid Injury CSF Abeta 42 Tau, p-tau sMRI - Hippocampal atrophyIWG PET Amyloid FDG - SPECT
  10. 10. Biomarker criteria IWG NIA-AA Amyloid Injury High + + Intermediate + ?Amyloid or injury markers ? + Uninformative + - - + Low - -
  11. 11. Biomarker criteria IWG NIA-AA Amyloid Injury High + + Intermediate + ?Amyloid or injury markers ? + Uninformative + - - + Low - -
  12. 12. Biomarker criteria IWG NIA-AA Amyloid Injury High + + Intermediate + ?Amyloid or injury markers ? + Uninformative + - - + Low - -
  13. 13. Biomarker criteria IWG NIA-AA Amyloid Injury High + + Intermediate + ?Amyloid or injury markers ? + Uninformative + - - + Low - -
  14. 14. Biomarker criteria IWG NIA-AA Amyloid Injury High + + Intermediate + ?Amyloid or injury markers ? + Uninformative + - - + Low - -
  15. 15. IWG versus NIA-AA IWG NIA-AA• Strengths • Strengths – Disease driven – Broad MCI definition – Takes into account availability biomarkers – Hierarchy biomarkers recognized• Limitations • Limitations – No hierarchy biomarkers – Position amyloid in – Prodromal AD term biomarker hierarchy – 3 different criteria
  16. 16. Challenges• Conflicting biomarkers• Standardization and cut-points• Validation• From diagnosis to prognosis

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