The importance of early diagnosis in Alzheimer's disease and mild cognitive impairment

Cerebrospinal fluid biomarkers (CSF) can support an early and accurate diagnosis of AD and MCI7

By 2050, the number of people affected by dementia is projected to reach 152 million worldwide¹

Dementia affects millions of people worldwide and is expected to triple by 2050.2 Alzheimer’s disease (AD) is the most common form of dementia and may contribute to 50-60% of cases.3

In 2015 the overall global cost of dementia was already USD 818 billion and is expected to increase to USD 2 trillion in 2030.2

Confirming a diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) is important and often a relief for the individual and their loved ones. Receiving a diagnosis early enables patients to make changes to their diet and lifestyles, which may slow the decline in their cognitive functions.1

In 2018, a mathematical model commissioned by the Alzheimer’s Association showed that the potential cost savings resulting from an early diagnosis of AD and MCI in medical and care costs could be USD 7.9 trillion by 2025.4

Two of the main hallmark signs of AD are the "plaques" and "tangles" that develop in the brain, caused by the build-up of, respectively, amyloid and tau proteins.6 The accumulation of amyloid beta and tau starts decades prior to symptom onset.5

CSF biomarkers support early and accurate diagnosis of MCI and AD, as these biomarkers reflect the specific pathological accumulation of amyloid beta in plaques and tau in neurofibrillary tangles.7

Amyloid beta (1-42) (Abeta42), phosphorylated tau (pTau) and total Tau (tTau) CSF biomarkers have been used in the research field for over 20 years.6 In 2018, the National Institute on Aging (NIA) at National Institutes of Health (NIH) and the Alzheimer's Association (NIA-AA) has proposed a new research framework which includes Abeta 42, pTau and tTau CSF biomarkers as core biomarkers to aid in the diagnosis of MCI and AD.6

References:

1. World Health Organisation. Dementia. [Internet; cited 2019 Nov 13]. Available from:

2. Alzheimer’s Disease International. World Alzheimer Report 2018. Available at:

4. Alzheimer’s Association. 2018 Alzheimer’s disease facts and figures. Alzheimer's Dement 2018; 14(3): 367-429.

5. Agamanolis D et al. (2016) Available at:

6. Jack CR et al. Alzheimers & Dement 2018; 14,535-562

7. Jack CR Jr, et al. Lancet Neurol 2010;9:119–28