The AT(N) Framework for Alzheimer's Disease in Adults with Down Syndrome

Overview

Journal Alzheimers Dement (Amst)

Date 2020 Nov 2

PMID 33134477

Citations 21

Authors

Michael S Rafii

Beau M Ances

Nicole Schupf

Sharon J Krinsky-McHale

Mark Mapstone

Wayne Silverman

Ira Lott

William Klunk

Elizabeth Head

Brad Christian

Florence Lai

H Diana Rosas

Shahid Zaman

Melissa E Petersen

Andre Strydom

Juan Fortea

Benjamin Handen

Sid OBryant

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Blood biomarkers in Down syndrome: Facilitating Alzheimer's disease detection and monitoring.

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Assessing amyloid PET positivity and cognitive function in Down syndrome to guide clinical trials targeting amyloid.

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Cerebrovascular disease emerges with age and Alzheimer's disease in adults with Down syndrome.

Lao P, Edwards N, Flores-Aguilar L, Alshikho M, Rizvi B, Tudorascu D Sci Rep. 2024; 14(1):12334.

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A pathway linking pulse pressure to dementia in adults with Down syndrome.

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Comparison of tau spread in people with Down syndrome versus autosomal-dominant Alzheimer's disease: a cross-sectional study.

Wisch J, McKay N, Boerwinkle A, Kennedy J, Flores S, Handen B Lancet Neurol. 2024; 23(5):500-510.

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