Alzheimer's disease. Issue 10284 (24th April 2021)

• Record Type: Journal Article
• Authors: Scheltens, Philip; De Strooper, Bart; Kivipelto, Miia; Holstege, Henne; Chételat, Gael; Teunissen, Charlotte E; Cummings, Jeffrey; van der Flier, Wiesje M
• Is Part Of: Lancet. Volume 397:Issue 10284(2021)
• Page Start: 1577
• Page End: 1590
• Publication Date: 2021-04-24
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(20)32205-4
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: In this Seminar, we highlight the main developments in the field of Alzheimer's disease. The most recent data indicate that, by 2050, the prevalence of dementia will double in Europe and triple worldwide, and that estimate is 3 times higher when based on a biological (rather than clinical) definition of Alzheimer's disease. The earliest phase of Alzheimer's disease (cellular phase) happens in parallel with accumulating amyloid β, inducing the spread of tau pathology. The risk of Alzheimer's disease is 60–80% dependent on heritable factors, with more than 40 Alzheimer's disease-associated genetic risk loci already identified, of which the APOE alleles have the strongest association with the disease. Novel biomarkers include PET scans and plasma assays for amyloid β and phosphorylated tau, which show great promise for clinical and research use. Multidomain lifestyle-based prevention trials suggest cognitive benefits in participants with increased risk of dementia. Lifestyle factors do not directly affect Alzheimer's disease pathology, but can still contribute to a positive outcome in individuals with Alzheimer's disease. Promising pharmacological treatments are poised at advanced stages of clinical trials and include anti-amyloid β, anti-tau, and anti-inflammatory strategies.