J b Mi t MD MBAJacobo Mintzer MD MBAJacobo Mintzer MD, MBAJacobo Mintzer MD, MBAJP f f N i d P hi t Professor of Neurosciences and Psychiatry Professor of Neurosciences and Psychiatry y y

M di l U i i f S h C li Medical University of South Carolina Medical University of South Carolina Medical University of South Carolina ySt ff Ph i i Staff Physician Staff Physician y

R l h H J h V M di l C Ralph H Johnson Veterans Medical Center Ralph H. Johnson Veterans Medical Center, Ralph H. Johnson Veterans Medical Center, p JCh l t SC USACharleston SC USACharleston, SC, USA, ,

D Mi t i j it f Dr Mintzer is majority owner of Dr Mintzer is majority owner of Dr. Mintzer is majority owner of j yBi h C th t h ld BiopharmaConnex a company that holds BiopharmaConnex a company that holds BiopharmaConnex, a company that holds BiopharmaConnex, a company that holds p p yh li d l Fl b i (AV 45) the lice ce to de elo Flo beta i (AV 45) the licence to develop Florbetapir (AV 45) the licence to develop Florbetapir (AV 45) the licence to develop Florbetapir (AV 45) p p ( )

i L ti A iin Latin Americain Latin Americain Latin America.at e ca

Fi t d ib d b Al i Al h i First described by Alois Alzheimer First described by Alois Alzheimer, y , G th l i t i 1907a German neuropathologist in 1907a German neuropathologist, in 1907.a German neuropathologist, in 1907.

Ob d i 51 ld f l ti t Observed in a 51 year old female patient Observed in a 51-year-old female patient Observed in a 51 year old female patient i h l di i i d

y pwith memory loss disorientation and with memory loss, disorientation, and with memory loss, disorientation, and h ll i i

yhallucinationshallucinationshallucinations.

Po t o te t die cha acte i ed e ile Postmortem studies characterized senile Postmortem studies characterized senile l d fib ill t l plaques and neurofibrillary tangles plaques and neurofibrillary tangles p q y g

(NFT ) i th b l t(NFTs) in the cerebral cortex(NFTs) in the cerebral cortex.( )

S il l E ll l Senile plaques: Extracellular Senile plaques: Extracellular Senile plaques: Extracellular l i f i l bl

p qaccumulation of insoluble accumulation of insoluble accumulation of insoluble fragments of beta amyloid (A� )fragments of beta-amyloid (A�1 42)fragments of beta amyloid (A�1-42)g y ( 1-42)

NFT I t ll l l ti NFTs: Intracellular accumulation NFTs: Intracellular accumulation NFTs: Intracellular accumulation f h h h l t d of hyperphosphorylated of hyperphosphorylated of hyperphosphorylated

t t dtau strandstau strandstau strands

N fib ill T l A l id l PlNeurofibrillary Tangles Amyloidal PlaquesNeurofibrillary Tangles Amyloidal Plaquesy g y q

Th i iti l di ti it i f th di bli h d b The initial diagnostic criteria for the disease were published by The initial diagnostic criteria for the disease were published by g p yh Al h i ’ A i i d h N i l I i f the Alzheimer’s Association and the National Institute of the Alzheimer s Association and the National Institute of the Alzheimer s Association and the National Institute of

Neurological and Communicative Disorders and Stroke in 1984 Neurological and Communicative Disorders and Stroke in 1984. Neurological and Communicative Disorders and Stroke in 1984. g

Ad i h d i th l t 28 h t d Advances in research during the last 28 years has generated new Advances in research during the last 28 years has generated new g y gk l d i ll th il bilit f bi kknowledge especially the availability of new biomarkersknowledge especially the availability of new biomarkers.g p y y

Formation of the workgroups was spearheaded by the Formation of the workgroups was spearheaded by the Formation of the workgroups was spearheaded by the ’

g p p yAl heimer’s Association and the National Instit te on Aging Alzheimer s Association and the National Institute on Aging Alzheimer s Association and the National Institute on Aging g g

(NIA) f th N ti l I tit t f H lth(NIA) of the National Institutes of Health(NIA) of the National Institutes of Health( )

Th l f h k d lib i bli h d i The results of these workgroups deliberations were published in The results of these workgroups deliberations were published in The results of these workgroups deliberations were published in 4 papers4 papers.4 papers.p p

Al h i ' & D ti Th J l f th Al h i ' Alzheimer's & Dementia: The Journal of the Alzheimer's Alzheimer s & Dementia: The Journal of the Alzheimer s JA i ti M 2011 V l 7 i 3Association on May 2011 Volume 7 issue 3Association on May 2011, Volume 7 issue 3y ,

Th i i l i i i h f d i The original criteria requires the presence of dementia The original criteria requires the presence of dementia The original criteria requires the presence of dementia g q p( l d d li i thi ki biliti (memory loss and a decline in thinking abilities severe (memory loss and a decline in thinking abilities severe (memory loss and a decline in thinking abilities severe ( y g

h t ff t d il lif )enough to affect daily life)enough to affect daily life)enough to affect daily life)g y )

’Th i i l it i b d hi fl d t ’ The original criteria were based chiefly on a doctor s The original criteria were based chiefly on a doctor s e o g c e e e e c e y o oc o’clinical judgment about the cause of a patient’s clinical judgment about the cause of a patient s clinical judgment about the cause of a patient s j g p

ki i f h i symptoms taking into account reports from the patient symptoms taking into account reports from the patient symptoms, taking into account reports from the patient, y p , g p p ,f il b d f i d lt f iti t ti family members and friends results of cognitive testing family members, and friends, results of cognitive testing, family members, and friends, results of cognitive testing, y g g

d l l i l tand general neurological assessmentand general neurological assessmentand general neurological assessmentg g

Th i i l it i ith l l f li i l The original criteria was concern with level of clinical The original criteria was concern with level of clinical e o g c e co ce e e o c ccertainty of the diagnosis (possible probable definitive)certainty of the diagnosis (possible probable definitive)certainty of the diagnosis (possible, probable, definitive)y g (p , p , )

P l d l l b h d i i f Postulated temporal lag between the deposition of Postulated temporal lag between the deposition of Postulated temporal lag between the deposition of p g pAβ d th li i l d f AD d ti Aβ and the clinical syndrome of AD dementia Aβ and the clinical syndrome of AD dementia Aβ and the clinical syndrome of AD dementia β y

Source: Alzheimer's & Dementia: The Journal of the Alzheimer's Association 2011; 7:280 292 (DOI:10 1016/j jalz 2011 03 003 )Source: Alzheimer s & Dementia: The Journal of the Alzheimer s Association 2011; 7:280-292 (DOI:10.1016/j.jalz.2011.03.003 )

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S Al h i ' & D i Th J l f h Al h i ' A i i 2011 7 280 292 (DOI 10 1016/j j l 2011 03 003 )Source: Alzheimer's & Dementia: The Journal of the Alzheimer's Association 2011; 7:280-292 (DOI:10.1016/j.jalz.2011.03.003 )Source: Alzheimer s & Dementia: The Journal of the Alzheimer s Association 2011; 7:280 292 (DOI:10.1016/j.jalz.2011.03.003 )

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Source: Alzheimer's & Dementia: The Journal of the Alzheimer's Association 2011; 7:280-292 (DOI:10.1016/j.jalz.2011.03.003 )Source: Alzheimer s & Dementia: The Journal of the Alzheimer s Association 2011; 7:280 292 (DOI:10.1016/j.jalz.2011.03.003 )

Copyright © 2011 Terms and ConditionsCopyright © 2011 Terms and Conditions