Abstract
INTRODUCTION
We aimed to evaluate the feasibility of the 2024 Alzheimer’s Association Workgroup’s integrated clinical-biological staging scheme in outpatient settings within a tertiary memory clinic.
METHODS
The 2018 syndromal cognitive staging system, coupled with a binary biomarker classification, was implemented for 236 outpatients with cognitive concerns. The 2024 numeric clinical staging framework, incorporating biomarker staging, was specifically applied to 154 individuals within the Alzheimer’s disease (AD) continuum.
RESULTS
The 2024 staging scheme accurately classified 95.5% AD. Among these, 56.5% exhibited concordant clinical and biological stages (canonical), 34.7% demonstrated more advanced clinical stages than biologically expected (susceptible), and 8.8% displayed the inverse pattern (resilient). The susceptible group was characterized by a higher burden of neurodegeneration and inflammation than anticipated from tau, whereas the resilient group showed the opposite.
DISCUSSION
The 2024 staging scheme is generally feasible. A discrepancy between clinical and biological stages is relatively frequent among symptomatic patients with AD.
Highlights
The 2024 AA staging scheme is generally feasible in a tertiary memory clinic.
A discrepancy between clinical and biological stages is relatively frequent in AD.
The mismatch may be influenced by a non-specific pathological process involved in AD.
Individual profiles like aging and lifestyles may contribute to such a mismatch.
Matched and mismatched cases converge toward similar clinical outcomes.
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This post is Copyright: Jiaying Lu,
Jing Wang,
Jie Wu,
Huiwei Zhang,
Xiaoxi Ma,
Yuhua Zhu,
Jie Wang,
Yunhao Yang,
Zhenxu Xiao,
Ming Li,
Xiaowen Zhou,
Zizhao Ju,
Qian Xu,
Jingjie Ge,
Ding Ding,
Tzu‐Chen Yen,
Chuantao Zuo,
Yihui Guan,
Qianhua Zhao,
the Shanghai Memory Study (SMS),
Qianhua Zhao,
Ding Ding,
Chuantao Zuo,
Keliang Chen,
Langfeng Shi,
Jiaying Lu,
Huiwei Zhang,
Weiqi Bao,
Xiaoniu Liang,
Zhenxu Xiao,
Xiaoxi Ma,
Jie Wu,
Jie Wang,
Xiaowen Zhou,
Wanqing Wu | September 17, 2024