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Clinical Manifestations.

Andrew M Kiselica1, Leslie S Gaynor2,3, Kelly J Atkins4,5

  • 1University of Georgia, Athens, GA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

This study proposes a Delphi protocol to define transitional cognitive decline (TCD) in early Alzheimer's disease (AD). Achieving consensus on TCD nomenclature and measurement is crucial for identifying individuals in Stage 2 of new AD diagnostic criteria.

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Area of Science:

  • Neuroscience
  • Clinical Psychology

Background:

  • New Alzheimer's disease (AD) diagnostic criteria include a six-stage staging schema (1-6).
  • Stage 2 is characterized by biomarker positivity and transitional cognitive decline (TCD) without impairment, lacking a clear clinical analogue.
  • Consensus on TCD definition is vital for early AD detection and clinical trial recruitment.

Purpose of the Study:

  • To outline a protocol for a Delphi study to establish consensus on the nomenclature and measurement of TCD in AD.
  • To ensure accurate identification of individuals in Stage 2 of the new AD diagnostic criteria.
  • To facilitate the development of interventions targeting the earliest stages of AD.

Main Methods:

  • A Delphi consensus study will be conducted, guided by a steering committee with expertise in TCD, Delphi studies, and mixed methods research.
  • A panel of approximately 30 experts will be selected to participate in the study.
  • Online surveys will be administered over three iterative rounds, with qualitative feedback analyzed to understand consensus drivers.

Main Results:

  • The study protocol includes Delphi panel selection, survey development focusing on TCD nomenclature and measurement, and iterative data collection.
  • Consensus will be defined as 75% agreement among panelists.
  • Qualitative feedback will be used to explore factors influencing consensus.

Conclusions:

  • The Delphi study will yield consensus-based resources for defining and measuring TCD.
  • These resources will inform clinical trial selection and analytic processes for early-stage AD interventions.
  • Establishing consensus on TCD is critical for advancing research and treatment for Alzheimer's disease.