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Highly Accessed Review

Assessing the progression of mild cognitive impairment to Alzheimer's disease: current trends and future directions

Larry G Brooks1 and David A Loewenstein23*

Author Affiliations

1 Department of Rehabilitation Medicine, Miller School of Medicine - University of Miami, P.O. Box 016960 (C-206), Miami, FL 33101, USA

2 Department of Psychiatry and Behavioral Sciences and Center on Aging, Miller School of Medicine, University of Miami, 1695 NW 9th Avenue, Suite 300, Miami, FL 33136, USA

3 Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA

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Alzheimer's Research & Therapy 2010, 2:28  doi:10.1186/alzrt52

Published: 29 September 2010

Abstract

With the advent of advances in biomarker detection and neuropsychological measurement, prospects have improved for identifying and tracking the progression of Alzheimer's disease (AD) from its earliest stages through dementia. While new diagnostic techniques have exciting implications for initiating treatment earlier in the disease process, much work remains to be done to optimize the contributions of the expanding range of tools at the disposal of researchers and clinicians. The present paper examines recent work in cerebrospinal fluid biomarkers, magnetic resonance imaging, positron emission tomography, neuropsychological measures, and functional assessment. The strengths and weaknesses of current methodologies are explored and discussed. It is concluded that AD from its mild cognitive impairment state through dementia represents a continuous process, and that progression over time can best be accomplished by interval-level variables. Biomarkers that are most sensitive to early AD may not be the most optimal for monitoring longitudinal change, and it is likely that multivariate models incorporating cognitive measures, functional variables and biomarker data will be the most fruitful avenues for future research.