Open AccessThe AT(N) framework for Alzheimer's disease in adults with Down syndrome
Author(s) -
Rafii Michael S.,
Ances Beau M.,
Schupf Nicole,
KrinskyMcHale Sharon J.,
Mapstone Mark,
Silverman Wayne,
Lott Ira,
Klunk William,
Head Elizabeth,
Christian Brad,
Lai Florence,
Rosas H. Diana,
Zaman Shahid,
Petersen Melissa E.,
Strydom Andre,
Fortea Juan,
Handen Benjamin,
O'Bryant Sid
Publication year - 2020
Publication title -
alzheimer's and dementia: diagnosis, assessment and disease monitoring
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.497
H-Index - 37
ISSN - 2352-8729
DOI - 10.1002/dad2.12062
Subject(s) - columbia university , medical school , gerontology , library science , research center , medicine , sociology , media studies , medical education , pathology , computer science
The National Institute on Aging in conjunction with the Alzheimer's Association (NIA‐AA) recently proposed a biological framework for defining the Alzheimer's disease (AD) continuum. This new framework is based upon the key AD biomarkers (amyloid, tau, neurodegeneration, AT[N]) instead of clinical symptoms and represents the latest understanding that the pathological processes underlying AD begin decades before the manifestation of symptoms. By using these same biomarkers, individuals with Down syndrome (DS), who are genetically predisposed to developing AD, can also be placed more precisely along the AD continuum. The A/T(N) framework is therefore thought to provide an objective manner by which to select and enrich samples for clinical trials. This new framework is highly flexible and allows the addition of newly confirmed AD biomarkers into the existing AT(N) groups. As biomarkers for other pathological processes are validated, they can also be added to the AT(N) classification scheme, which will allow for better characterization and staging of AD in DS. These biological classifications can then be merged with clinical staging for an examination of factors that impact the biological and clinical progression of the disease. Here, we leverage previously published guidelines for the AT(N) framework to generate such a plan for AD among adults with DS.