Meeting Report
Early risk assessment for Alzheimer’s disease
Maria C. Carrillo
a,
*
, Andrew Blackwell
b
, Harald Hampel
c
, Johan Lindborg
d
, Reisa Sperling
e
,
Dale Schenk
f
, Jeffrey J. Sevigny
g
, Steven Ferris
h
, David A. Bennett
i
, Suzanne Craft
j
,
Timothy Hsu
k
, William Klunk
l
a
Alzheimer’s Association, Chicago, IL, USA
b
Cambridge Cognition, Bottisham, Cambridge, United Kingdom
c
Department of Psychiatry, School of Medicine, Trinity College, University of Dublin, and Laboratory of Neuroimaging and Biomarker Research, Trinity College
Institute of Neuroscience, Dublin, Ireland, and Alzheimer Memorial Center, Department of Psychiatry, University of Munich, Munich, Germany
d
Eli Lilly & Co., Indianapolis, IN, USA
e
Brigham and Women’s Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA
f
Elan Corp., South San Francisco, CA, USA
g
Merck Research Laboratories, North Wales, PA, USA
h
New York University School of Medicine, Department of Psychiatry, New York, NY, USA
i
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
j
Veterans Administration Puget Sound Health Care System, University of Washington School of Medicine, Seattle, WA, USA
k
Eisai Global Clinical Development, Ridgefield Park, NJ, USA
l
University of Pittsburgh Medical School, Department of Psychiatry, Pittsburgh, PA, USA
Abstract The purpose of the Alzheimer’s Association Research Roundtable meeting was to discuss the po-
tential of finding diagnostic tools to determine the earliest risk factors for Alzheimer’s disease (AD).
Currently, drugs approved for AD address symptoms which are generally manifest after the disease is
already well-established, but there is a growing pipeline of drugs that may alter the underlying pathol-
ogy and therefore slow or halt progression of the disease. As these drugs become available, it will be-
come increasingly imperative that those at risk for AD be detected and possibly treated early,
especially given recent indications that the disease process may start decades before the first clinical
symptoms are recognized. Early detection must go hand-in-hand with qualified tools to determine the
efficacy of drugs in people who may be asymptomatic or who have only very mild symptoms of the
disease. Devising strategies and screening tools to identify and monitor those at risk in order to perform
‘‘prevention’’ trials is seen by many as a top public-health priority, made all the more urgent by an
impending growth in the elderly population worldwide.
Ó 2009 The Alzheimer’s Association. All rights reserved.
Keywords: Alzheimer’s disease; Scale development; Early detection; Drug discovery; Biomarkers; Qualification; Epidemiol-
ogy; Risk assessment
1. Introduction
From the United States perspective, great strides have been
made in the diagnosis of Alzheimer’s disease (AD) over the
last few decades. Whereas 20 years ago physicians would
have agonized over a diagnosis for someone with symptoms
of mild AD, Alzheimer’s disease centers now routinely
make AD diagnoses with 90% accuracy [1]. The next chal-
lenge appears to be twofold: 1) to transfer that diagnostic suc-
cess to nonspecialist centers and the general population, and
2) to push that diagnosis earlier in the disease, into the preclin-
ical phase, and even into the presymptomatic phase (Fig. 1)
[2]. There are obstacles to both goals. Non-specialists in the
general community may not have adequate experience or
training in cognitive disorders. They may also be hesitant to
make a diagnosis of a disease that is progressive and without
a cure. However, because disease-modifying therapies will
likely be most efficacious at earlier stages of the disease
*Corresponding author. Tel.: 312-335-5722.
E-mail address: Maria.Carrillo@alz.org
1552-5260/09/$ – see front matter Ó 2009 The Alzheimer’s Association. All rights reserved.
doi:10.1016/j.jalz.2009.01.019
Alzheimer’s & Dementia 5 (2009) 182–196