Professor Ji Yong interviewed: Alzheimer's disease to achieve clinical early screening and early diagnosis, how far away is we

Based on current research, lesions in the human brain are quietly changing 15 to 20 years before the clinical manifestations of AD, so to achieve diagnostic and treatment interventions in the prime time before clinical manifestations, the time window for detection needs to be moved
forward.

1.

In the latest "Alzheimer's Disease Preclinical Awareness Rate and Consultation Rate Survey", it was found that the public's awareness and attention to Alzheimer's disease still needs to be strengthened, and people often have a good period of time because of the recent work and life pressure; Now the symptoms are very mild, there should be no big problem; Usually the work is too busy, there is no time and other factors to affect its subjective treatment, and even some people think that people will have Alzheimer's disease after aging, and there is no need to go to the doctor
.

2.

The current method of clinical diagnosis of AD is to detect relevant biomarkers in cerebrospinal fluid and PET imaging, but these two methods are invasive and less hospital-available, and are often not suitable for early screening
.

3.

In the latest "Chinese Expert Consensus on the Diagnosis and Treatment of Alzheimer's Mild Cognitive Impairment of Disease Origin" released in May this year, it was proposed that β⁃amyloid 42 (amyloid β⁃protein 42, Aβ42), β⁃amyloid 40 (amyloid β⁃protein 40, Aβ40), phosphorylated tau protein (phosphorylated tau, P⁃) detected by single-molecule immune array technology (Simoa technology) TAU)181 and neurofilament light chain (NfL) have been shown to have a good correlation with CSF and PET results, with the potential to replace CSF and PET testing
.

4.

One-third of people over the age of 80 have Alzheimer's disease, but Alzheimer's disease does not only occur in the elderly
.

Professor Ji Yong

• Doctor of Medicine, Doctor of Science, Chief Physician, Professor, Member of the Neurology Association of the Chinese Medical Doctor Association, Member of the Dementia and Cognitive Impairment Group of the Neurology Branch of the Chinese Medical Association
  .
  
  

• Since 1989, AD research, engaged in clinical and basic research on memory and dementia in the United States and Japan for 20 years, created the Tianjin Dementia Research Institute and the Dementia Group of Neuromolecular Imaging, mainly engaged in the research of memory and dementia, clinical diagnosis and mechanism, and published more than 60 SCI research results including JNM in the past five years as the first or corresponding author
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Expert reviews

The main neuropathological proteins of AD are Neuritic plaques and neurofibrillary tangles, which are also the gold standard
for diagnosing AD.

The changes in these two pathological proteins, which can be gradually determined by neuromolecular imaging and cerebrospinal fluid examination, make it possible to clinically confirm the diagnosis of AD, and gradually apply to the clinical diagnosis and differential diagnosis, and also become an important indicator
for observing the treatment effect.

Although neuromolecular imaging and CSF are both sensitive and specific, there are significant limitations, high costs and increased patient pain, making it difficult to generalize and repeat the test
.

From five years ago, through blood tests to confirm amyloid in the human brain and the response to Neurofibrillary tangles tau began to report, with the advancement of technology, blood tests to diagnose AD sensitivity and specificity gradually improved, and repeatability and stability is good, gradually accepted and promoted by clinicians and researchers, looking forward to the near future can replace the examination
of cerebrospinal fluid.