When Does Alzheimer Disease Start?

A study of familial AD suggests the disease starts more than 20 years before clinical symptoms develop.

The pathological process of Alzheimer disease (AD) begins before the clinical symptoms manifest. To identify the timing and stages of this process, researchers examined biological markers of AD in 128 individuals who had a parent with dominantly inherited AD (carriers of the APP, PSEN1, or PSEN2 gene mutation). The researchers tested the participants for carrier status of the relevant gene. Using the affected parent's age at onset and the participant's age at assessment, the researchers estimated the years to symptom onset and identified correlations with biological and clinical AD parameters.

Of the 128 participants, 88 were AD gene carriers (mean age at assessment, 39). Levels of amyloid-beta (Aβ)₄₂ in the cerebrospinal fluid (CSF) appeare…

Reviewing Authors

Brandy R. Matthews, MD

Disclosures

Grant / Research supportNational Institute on Aging

Brandy R. Matthews, MD

Disclosures

Grant / Research supportNational Institute on Aging

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

When Does Alzheimer Disease Start?

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Reviewing Authors