Revised criteria for diagnosis of Alzheimer's disease: National Institute on Aging‐Alzheimer's Association diagnostic guidelines for Alzheimer's disease

The publication of revised criteria/guidelines for the diagnoDx-AD criteria and offer recommendations for further sis of Alzheimer’s disease (Dx-AD) in the current issue of Alzheimer’s & Dementia is a momentous milestone in the prolonged history of efforts to characterize the distinct clinical-pathological features of a complex syndrome—Alzheimer’s disease (AD). The amendments to the current criteria recommended by the National Institute on Aging (NIA)-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease represent significant progress in that endeavor by adding important new features that would enhance the precision and accuracy of differential diagnosis of this syndrome. These revisions promise to have a profound impact on the pace and direction of future research as well as the global effort to find a cure. Our field owes a great debt of gratitude to the members of the three workgroups, as well as to the NIA and the Alzheimer’s Association, for their leadership in crafting the first significant revision of the NINCDS-ADRDA (National Institute of Neurological and CommunicativeDisorders and Stroke and theAlzheimer’sDisease and Related Disorders Association) criteria [1] of 1984. Much of what the NIA-Alzheimer’s Association workgroups are recommending is a redefinition of AD to include 3 stages: 1) a dementia stage for which the original NINCDS/ADRDA and the revised National Institute on Aging/Alzheimer’s Association criteria apply; 2) a mild cognitive impairment (MCI) stage where there are core criteria forMCI but only guidelines of how to relateMCI to AD after further research and validation of biomarkers; and 3) a preclinical stagewhere there are no criteria for diagnosis but, instead, presentation of a staging hypothesis for further research related to the use of biomarkers to identify people with changes in the brain consistent with those seen later in MCI and AD dementia. An important point for all three stages is that the workgroups have created a framework for research on the relationship of the underlyingpathophysiology to the emergence of clinical symptoms. In addition, for MCI and AD dementia, basic diagnostic criteria for use in current clinical practice are presented. The purpose of this editorial is to provide a brief historic context to the significance of the proposed revisions to the