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Disease staging and milestones.

Kiran Rabheru1

  • 1Vancouver General, UBC and Riverview Hospitals, Vancouver, BC, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|May 2, 2007
PubMed
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Clinical milestones are vital for tracking Alzheimer's disease progression and developing targeted therapies. Expanding dementia definitions beyond cognition is recommended for comprehensive patient care.

Area of Science:

  • Neurology
  • Clinical Trials
  • Geriatrics

Background:

  • Alzheimer's disease (AD) diagnosis and treatment historically focus on cognitive decline.
  • There is a growing need to understand disease progression beyond cognitive measures.
  • Clinical milestones offer valuable insights into the multifaceted nature of AD.

Purpose of the Study:

  • To review clinical milestones relevant for Alzheimer's disease clinical trials.
  • To explore the potential of biological and surrogate markers as future milestones.
  • To advocate for a broader definition of dementia in clinical practice and research.

Main Methods:

  • Literature review of clinical milestones in Alzheimer's disease.
  • Analysis of existing and potential markers for disease staging.

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  • Synthesis of current guidelines and recommendations.

    • Main Results:

    • Identified key clinical milestones including global function, daily function, behavior, caregiver burden, and quality of life.
    • Discussed the potential utility of biological and surrogate markers in clinical trials.
    • Highlighted the limitations of cognition-centric dementia definitions.

    Conclusions:

    • Clinical milestones are crucial for advancing stage-specific therapies in Alzheimer's disease.
    • Biological and surrogate markers may offer objective measures for future clinical milestones.
    • Dementia definitions should be expanded to encompass non-cognitive domains for holistic patient assessment.