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New Criteria for Alzheimer Disease and Mild Cognitive Impairment: Implications for the Practicing Clinician

Budson, Andrew E. MD*,†,‡; Solomon, Paul R. PhD‡,§

doi: 10.1097/NRL.0b013e31826a998d
Invited Review Articles

Background: In most research studies and clinical trials, Alzheimer disease (AD) has been diagnosed using the criteria developed by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association work group in 1984. Developments over the last 27 years have lead to the need for new diagnostic criteria.

Review Summary: Four articles in the journal Alzheimer’s & Dementia in 2011 describe new criteria for AD dementia and mild cognitive impairment (MCI) due to the AD pathophysiological process (MCI due to AD) and the underlying rationale for them. These new criteria emphasize that the AD pathophysiological process starts years and perhaps decades before clinical symptoms, and that biomarkers can be used to detect amyloid β deposition and the effects of neurodegeneration in the brain.

Conclusions: These new criteria are immediately helpful to the practicing clinician, providing more accurate and specific guidelines for the diagnosis of AD dementia and MCI due to AD. As new diagnostic tools and new treatments for AD become available, diagnosis using these criteria will enable patients with this disorder to receive the best possible care.

*Center for Translational Cognitive Neuroscience, VA Boston Healthcare System

Boston University Alzheimer’s Disease Center, Boston University School of Medicine, Boston

§Department of Psychology, Program in Neuroscience, Williams College, Williamstown, MA

The Memory Clinic, Bennington, VT

Supported by National Institute on Aging grant P30 AG13846. This material is also the result of work supported with resources and the use of facilities at the VA Boston Healthcare System.

The authors declare no conflict of interest.

Reprints: Andrew E. Budson, MD, VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, Boston, MA 02132. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.