Dr. Petersen’s summarized the history of the US National Alzheimer’s Project Act (NAPA), passed by Congress in December 2010, signed by the president in January 2011, and the start of the activity of the Advisory Committee Meeting (N=25). The NAPA process includes better use of existing resources and planning for new resources towards effectively treating AD by 2025. The current US budget for research in AD is approximately $450M/year and NAPA aims at $2B/year. Two expert meetings are taking place in Washington for AD (May 2012) and non-AD dementias (May 2013).
He then reviewed the new criteria for AD published in Alzheimer’s & Dementia, May 11th 2011, which incorporate biomarkers for molecular neuropathology (CSF AB42, Amyloid PET) and for measures of neuronal injury (MRI, FDG-PET, CSF tau), at the dementia, MCI (or prodromal) and pre-symptomatic stages.
The case of a 53 year old woman with “MCI due to AD” progressing over two years to “dementia due to AD” illustrated the applicability of these criteria for a specialized clinical population.
He then summarized findings from the Mayo Clinic Study of Aging involving 3,000 nondemented subjects age 50-89 from the Olmsted County, MN, demonstrating that in a general population annual rates of changes from cognitively normal to MCI and to dementia are influence by biomarker positivity, particular if both biomarkers for molecular neuropathology and for measures of neuronal injury are abnormal. A group of special interest in that of subjects with no cognitive symptoms but with abnormal measures of neuronal injury despite no evidence of amyloid pathology (suspected non-amyloid pathophysiology SNAP).
His conclusion was that the new criteria for AD work in general but need cut points for defining normal vs abnormal, confirmation of temporal ordering of biomarker changes, cost assessment.
Serge Gauthier
April 22, 2013