Lesson 1Definitions and current diagnostic criteria (NIA-AA 2011/2018 research framework, IWG)Dis one summarize big diagnostic criteria for Alzheimer’s disease, including NIA-AA 2011, NIA-AA 2018 research framework, and IWG criteria. E go show conceptual changes toward biological definitions and wetin e mean for clinic use versus research.
Core elements of NIA-AA 2011 clinical criteriaNIA-AA 2018 biological definition and AT(N) useKey features of IWG diagnostic criteriaDifferences between clinical and research criteriaImplications for trial enrollment and labelingLesson 2When and how to combine biomarkers (CSF, blood, PET, MRI) to increase diagnostic certaintyDis part explore ways to mix CSF, blood, structural MRI, and PET biomarkers to make diagnosis more sure. E go talk about matching and mismatching patterns, test order, and mixing results with clinical signs and disease stage.
Principles of multimodal biomarker integrationCommon concordant and discordant result patternsSequential versus parallel testing strategiesAligning biomarker choice with disease stageCommunicating combined results to patientsLesson 3Molecular neuroimaging: amyloid PET and tau PET — indications, reading, quantitation, and regional patternsDis focus on amyloid and tau PET imaging, including when to use, when not, and how to read dem. E go discuss regional uptake patterns, number metrics, pitfalls, and how PET results affect diagnosis and management.
Appropriate use criteria for amyloid PETTypical amyloid PET regional uptake patternsTau PET tracers and distribution in Alzheimer’sVisual reads versus quantitative PET measuresCommon artifacts and interpretive pitfallsLesson 4Structural and functional imaging: MRI (atrophy patterns, volumetry), FDG-PET — differential diagnostic utilityDis explain structural MRI and FDG-PET findings in Alzheimer’s disease and other diagnoses. E review characteristic atrophy and low metabolism patterns, number tools, and how imaging support or challenge suspected diagnosis.
Medial temporal and parietal atrophy patternsVisual rating scales and volumetric quantificationFDG-PET hypometabolism in Alzheimer’s diseaseImaging clues to non-Alzheimer’s dementiasIntegrating MRI and FDG-PET with clinical dataLesson 5Practical algorithms for ordering tests given cost, availability, and patient comorbidity constraintsDis provide step-by-step ways to pick biomarker tests under cost, access, and patient health issue limits. E stress tailoring strategies to clinical question, healthcare place, and patient wishes while avoiding extra or low-value testing.
Initial cognitive workup before biomarker testingChoosing CSF versus blood biomarkersWhen to add amyloid or tau PET imagingAdapting algorithms to comorbidities and frailtyCost, insurance coverage, and health system limitsLesson 6Established fluid biomarkers: CSF Aβ42/40, total tau, phosphorylated tau assays — interpretation and limitationsDis detail established CSF biomarkers Aβ42, Aβ42/40 ratio, total tau, and phosphorylated tau. E explain test platforms, cutoffs, and typical Alzheimer’s patterns, plus test changes, gray areas, and non-Alzheimer’s causes of bad results.
CSF Aβ42 and Aβ42/40 ratio: biology and cutoffsTotal tau as a marker of neuronal injuryPhosphorylated tau isoforms and assay platformsInterpreting discordant or borderline CSF profilesNon-Alzheimer’s conditions affecting CSF markersLesson 7Blood-based biomarkers: plasma p-tau (181, 217), Aβ42/40, neurofilament light (NfL) — validity, thresholds, and preanalytical issuesDis cover blood-based biomarkers including plasma p-tau181, p-tau217, Aβ42/40, and neurofilament light. E discuss test truth, thresholds, sample handling before test, and how blood tests compare with CSF and PET in different places.
Biology and kinetics of plasma p-tau isoformsPlasma Aβ42/40 ratio and assay approachesNeurofilament light as a nonspecific injury markerPreanalytical factors affecting plasma biomarkersClinical scenarios suited to blood-based testingLesson 8Clinical phenotypes of Alzheimer’s disease and typical progression patternsDis describe typical and unusual clinical types of Alzheimer’s disease, including memory loss, posterior cortical, logopenic, and frontal types. E review progression patterns, function drop, and how type link to biomarker profiles.
Typical amnestic late-onset Alzheimer’s presentationPosterior cortical atrophy and visuospatial deficitsLogopenic variant primary progressive aphasiaFrontal and behavioral-predominant Alzheimer’sLongitudinal progression and functional milestonesLesson 9Biomarker-based staging (AT(N) framework) and linking biomarkers to clinical stageDis introduce biomarker-based staging using AT(N) framework, linking amyloid, tau, and neurodegeneration markers to clinical stage. E cover staging plans, typical paths, and how AT(N) inform prognosis and trial fit.
Conceptual basis of the AT(N) classificationMapping AT(N) profiles to clinical stagesLongitudinal change in AT(N) over the disease courseUsing AT(N) for prognosis and risk communicationLimitations and controversies of AT(N) stagingLesson 10Preanalytical, laboratory quality, and regulatory considerations for biomarker testingDis review sample handling before test, test validation, and quality systems for Alzheimer’s biomarkers. E cover accreditation, regulation paths, and reporting standards to make sure reliable, useful test results across labs.
Sample collection tubes and timing requirementsCentrifugation, aliquoting, and storage conditionsInternal quality control and external proficiency testingRegulatory approval pathways and labeling limitsStandardized reporting formats and reference ranges
