Very mild Alzheimer's disease

Abstract

We compare clinicopathologic data from 10 subjects identified in the very mild stage of senile dementia of the Alzheimer type with findings from similar studies in four cognitively normal subjects. We based the diagnosis of very mild dementia in the 10 subjects on informant reports and the judgment of experienced clinicians. Deficits of some psychometric measures of memory, language, and speeded psychomotor performance were observed for these subjects. The histologic markers of Alzheimer's disease, including neurofibrillary tangles and both the "diffuse" and classic subtypes of senile plaques, were present in the neocortex in all 10 subjects but essentially were absent in the four controls. These findings indicate that even "questionable" dementia can be diagnostic for Alzheimer's disease. Furthermore, because truly normal aging may be unaccompanied by neocortical senile plaques and neurofibrillary tangles, the presence of these lesions should suggest the possibility of clinically undetected Alzheimer's disease.

Tau protein concentrations in cerebrospinal fluid of patients with dementia of the Alzheimer type.

“…Because the MSE test examines patient cognitive function, the measurement of CSF tau protein might provide a correlation with the psychological symptoms and severity of disease. As in other studies,6 19 the appearance of tangles within the neocortex is a reliable marker for the presence of DAT and higher neocortical tangle densities are associated with more severe dementia.…”

“…Some studies3 19 that quantify tau protein in brain tissues indicate that its relation is with severity of dementia, but not with age of patients with DAT, and that its concentrations could distinguish DAT from processes occurring during normal aging. Vandermeeren et all' have found increased CSF tau values in patients with DAT and controls older than 60, but not in patients who had other diseases of the CNS.…”

Can Clinical Data Predict Progression to Dementia in Amnestic Mild Cognitive Impairment?

“…There were 45 men and 45 women, with an average of 10.7 years of education (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. The mean duration of reported memory loss prior to presentation was 2.6 years (SD 2.1), with the mean age at symptom onset 71.1 years (SD 8.2).…”

“…While cognitive "domains" of memory, orientation, judgment, social function, hobbies, and personal hygiene are all assessed, the algorithm for calculating the rating weights memory heavily. 8 It has been noted, however, that although most MCI individuals score as CDR 0.5, there are some other CDR 0.5 individuals who would be better classified as already demented, with mild AD. 9,10 Another term, Age-Associated Cognitive Decline applies to patients who report gradual cognitive decline over at least six months.…”

“…16 Relatives' report of memory deterioration also appears to accurately detect mild cognitive impairment even in the absence of measurable neuropsychological deficits. 8,[51][52][53] It is not clear that new neuropsychological subtypings of MCI lead to any increase in predictive ability. 54 There is growing evidence that signs and symptoms of vascular disease are important risks for dementia, and even for AD.…”