Professor Chen Biao: It is not too late to understand the staging and intervention of Alzheimer's disease!

*It is only for medical professionals to read and reference.
I hope that the research results will come to an end as soon as possible, bringing new hope to the diagnosis and treatment of Alzheimer's disease
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 Expert Profile: Professor Chen Biao, Doctor of Medicine, Professor, Chief Physician, and Doctoral Supervisor; Director of the National Center for Geriatric Diseases Clinical Medicine; Xuanwu Hospital of Capital Medical University
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Part-time: Vice Chairman of the Chinese Medical Association Geriatrics Branch, Vice Chairman of the Chinese Medical Doctor Association Geriatrics Branch, Chairman of the Beijing Medical Association Geriatrics Branch, Vice Chairman of the Chinese Geriatrics Association, International Parkinson and Movement Disorders Society Telemedicine Committee Member, co-chair of the Education Committee of the Asia-Pacific Division of the International Parkinson and Movement Disorder Society
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Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive memory loss and cognitive impairment
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According to the first "Survey Report on the Diagnosis and Treatment Status of Alzheimer's Disease Patients in China" released in April this year, there are currently 15.
07 million dementia patients in the population of 60 years and older in China, of which 9.
83 million are AD patients
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AD has become a major disease affecting the health of the elderly, and China is facing a severe disease situation
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 However, compared with the large number of patients, low public awareness, low patient visit rate, lack of innovation and effective radical treatment methods, etc.
, are the basic status quo in the diagnosis and treatment of AD in China.
Development poses severe challenges and higher requirements
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 Every September is World Alzheimer's Disease Month, and the theme of this year's World Alzheimer's Month is "Knowing the enemy and knowing the past, early diagnosis and early wisdom"
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Taking this opportunity, the "medical community" invites Professor Chen Biao from Xuanwu Hospital of Capital Medical University to exchange views on hot issues of concern to readers.

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 Have you got the clinical staging of AD? AD is an insidious onset and progressive disease.
Professor Chen Biao first introduced the clinical staging of AD
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He pointed out that AD is generally staged according to clinical symptoms and manifestations, mainly divided into early mild cognitive impairment (MCI); early, middle and late AD
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 In the early stages of onset, patients usually present with MCI.
At this stage, patients cannot be diagnosed as AD, but patients have a series of symptoms of cognitive decline, which have no significant impact on the quality of life of patients
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Since most MCI patients will progress to AD in a few years or even longer, we usually regard the MCI stage as the preclinical stage of AD
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 Early, middle and late AD patients show a series of cognitive impairments, the most prominent manifestation is memory problems, and secondly, patients also show mental symptoms and personality changes, which will affect the patients' daily life and work ability
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 The symptoms of AD patients of different clinical stages are also different.
There are differences in memory impairment, the severity of mental symptoms and personality changes.
The main criterion for staging is the patient's personal living ability
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Generally, patients with early AD can still manage themselves, go to work, or complete daily housework and washing
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After entering the middle stage, the work is more affected, but the patient still has a certain ability of daily living with help.
For example, although the calculation of money is not accurate, he can still complete daily tasks such as grocery shopping; the patient can still go out on his own, but occasionally it may be difficult Return home on your own
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After the development of advanced AD, the patient is in a state where he is completely unable to take care of himself and completely needs others to take care of him
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 For the diagnosis of AD, in order to enable patients to be diagnosed earlier and adopt various strategies to delay the occurrence and development of AD, more active diagnostic criteria for AD are also adopted in current clinical research
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If a patient has measurable biomarkers for AD (for example, β-amyloid plaques commonly known as senile plaques in the brain), but no clinical symptoms related to AD appear, AD can also be diagnosed
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That is, pathological features such as β-amyloid plaques rather than clinical symptoms are used as the diagnostic criteria for AD.
It is hoped that there will be more drugs that can actively intervene in response to this pathological change in the future
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 AD intervention is never too late! When talking about the intervention time window of AD, Professor Chen Biao pointed out that intervention measures can be taken at any stage of AD, and the difference is only the purpose of intervention
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 Intervention when there is no disease (for example, only β-amyloid plaques are deposited without clinical symptoms) is to delay the occurrence of the disease, and even achieve the goal of not having the disease during the lifetime
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Intervention in the early stage is to prevent the disease from progressing to the middle and late stages, so that patients can maintain the ability to take care of themselves
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If the patient has only some clinical symptoms (for example, only memory loss), drug and non-drug intervention can also be used to reduce the appearance of mental symptoms and improve the quality of life as much as possible
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 In terms of specific intervention measures, in addition to existing drugs and rehabilitation methods, there are currently some drugs targeting β-amyloid, such as antibodies, vaccines, small molecule drugs, Chinese medicines, etc.
, with the goal of reducing or eliminating β-amyloid Protein plaques delay the occurrence and development of AD.
At present, it has shown a certain effect in animal models and human studies.
It is progressing rapidly and is a promising clinical research direction
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In addition, research on pathways such as Tau protein and other metabolic links of cells and neurons is also under development, but the current evidence is not sufficient.
It is hoped that through further research, the drug will be released earlier and provide a more powerful therapeutic weapon for the clinic
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 The International Symposium on the Clinical Transformation and Treatment of Brain Aging and Neurodegenerative Diseases will be held on September 26-27, chaired by Professor Chen Biao and Professor Shen Yong from the University of Science and Technology of China, "Clinical Transformation of Brain Aging and Neurodegenerative Diseases" "International Symposium on Treatment and Treatment" will be held in Beijing.
The content of this conference covers Parkinson's disease (PD) and AD, the two most common neurodegenerative diseases in the elderly
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PD mainly affects human motor function, while AD mainly affects cognitive abilities including memory, judgment, and thinking, which brings great distress to the elderly
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These two diseases have a common pathogenesis, that is, the degeneration of nerve cells and the accumulation of abnormal proteins
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 This conference will invite well-known experts at home and abroad to discuss AD and PD biomarkers, early warning signals, pathological targets, high-risk groups and other issues, share clinical research design experience, drug development experience, and exchange their work progress.
Hope to pass The efforts of the academic community have developed more disease-modifying treatment drugs for PD and AD, which will bring a better future to patients
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 For more exciting content of the conference, please refer to the poster