It is sufficient to justify distinguishing age-appropriate and age-inappropriate forms of age-related memory decline. The former, of which AAMI is an example, represents a normal age-related phenomenon, whereas the latter, the true descendent of benign senescent forgetfulness, is by definition abnormal and possibly, pathological. Whether age-inappropriate forgetfulness is progressive, whether it can be distinguished from other concepts of mild cognitive decline by virtue of being specific to memory, and whether it is qualitatively different from normal memory or merely worse is not yet certain. The prevalence of age-inappropriate forgetfulness is undetermined, but it is certainly less common than AAMI. The construct of AAMI was introduced by an NIMH work group. It was the group's declared intention to facilitate communication and stimulate research into late-life memory loss, particularly its treatment. Completely satisfactory diagnostic criteria do not yet exist for AAMI. Improved criteria would take an individual's overall level of intellectual functioning or educational background into account when setting the standard against which to rate memory, distinguish age-appropriate from age-inappropriate decline. AAMI differs from BSF in several points. First, the AAMI criteria define impairment with respect to healthy young adult levels, not to those of the older individual's age peers as was implied in the description of BSF. Second, the term AAMI is non-specific with regard to etiology and does not necessarily imply that the disorder is non-progressive. Thus, patients whose memory impairment is subsequently shown to be the earliest stage of a dementing illness are not necessarily excluded from the category of AAMI, and it is sensible to ask how often AAMI is, in fact, a dementia prodrome.
Aging ; Dementia ; Humans ; Intention ; Memory Disorders ; Memory* ; National Institute of Mental Health (U.S.) ; Prevalence ; Virtues ; Young Adult

Diagnostic guidelines for the preclinical, mild cognitive impairment, and dementia stages of Alzheimer's disease (AD) were released by the National Institute on Aging and Alzheimer's Association (NIA-AA) in 2011. Promoted by the subsequent scientific progress, a unifying update, the ‘NIA-AA Research Framework', was published in 2018. This new research framework shifts the definition of AD from syndrome to biological construct based on biomarkers in living people. The biomarkers were grouped into β amyloid deposition (A), pathologic tau (T), and neurodegeneration (N) related, termed the ‘AT(N) classification system#x2019;, which could be extended with new biomarkers as they become available in the future. For the staging of cognitive impairment, three syndromal stages for observational studies and six numeric stages for clinical trials were also suggested. This biomarker-based classification combined with clinical staging is expected to enhance the understanding of AD as well as aid in precise targeting for interventional clinical trials. This review focused on the introduction of the new 2018 NIA-AA Research Framework. Although this framework has been proposed for research purposes, it is expected to be adopted into general clinical practice with thorough examination and validation in the future.
Alzheimer Disease ; Biomarkers ; Classification ; Cognition Disorders ; Dementia ; Mild Cognitive Impairment ; National Institute on Aging (U.S.) ; Plaque, Amyloid

Alzheimer's disease (AD) is an age-related neurodegenerative disorder. It is expected that the incidence of AD will increase exponentially in the coming decades. The clinical and research application of AD biomarkers has gone through a long process. At present, the clinical diagnostic criteria for AD mainly include the IWG-2 criteria developed by International Working Group (IWG), the NIA-AA criteria formulated by the National Institute on Aging and Alzheimer's Association (NIA-AA) and the "Guidelines for the Diagnosis and Treatment of Alzheimer's Disease in China (2020 version)" released by the Professional Committee on Alzheimer's Disease and Related Diseases of the Chinese Geriatric Health Care Association (Alzheimer's Disease Chinese, ADC). Cerebrospinal fluid biomarkers such as Aβ₄₂, T-tau and P-tau are recognized as central biomarkers for AD, besides, the development of new molecules in other pathophysiological pathway that can be used as biomarkers for the diagnosis of AD have made great progress in the last decade. This article elaborates studies of the application guidelines of AD biomarkers and highlights the research progress of biomarkers in AD pathophysiological pathway.
Aged ; Alzheimer Disease/diagnosis* ; Biomarkers ; China ; Humans ; National Institute on Aging (U.S.) ; United States

BACKGROUND: Aging and obesity are both positive determinants of chronic disease in the elderly. This study was done to examine the relationship between obesity and functional status and, to examine the relationship between comorbidity and the different levels of BMI among older Koreans. METHODS: A total of 920 community dwelling women and men who completed both the home questionnaire and medical examination that was conducted in 1998 were chosen as subjects. The proportion of subjects with prevalence of obesity-related diseases and functional limitation by NHLBI classifications was determined. Risks for functional limitation associated with comorbidity of obesity-related diseases and fat distribution were examined using multivariate adjusted logistic regression methods. RESULTS: Among 920 subjects studied, 91% were functionally independent. The underweight were one in ten and the overweight were one in four. The overall prevalence of functional limitation in a major activity among underweight was one in ten, but that of overweight or over was one in two. After multivariate adjustment, significant predictors for functional limitation in ADLs and IADLs were vision and hearing impairment, unemployed occupational status, depression, living with spouse, and a history of stroke. Though not significantly shown in the statistics, comorbidity (>or=3) of six obesity-related diseases had odds of 5.4 times and in obese elderly women the odds were 7.9 times. CONCLUSION: We suggest that there is a positive trend between overweight and functional limitation. Although there is no statistical significance, obesity in older Korean women had higher odds for functional limitation in ADLs and IADLs.
Activities of Daily Living ; Aged* ; Aging ; Chronic Disease ; Classification ; Comorbidity ; Cross-Sectional Studies ; Depression ; Employment ; Female ; Hearing Loss ; Humans ; Logistic Models ; Male ; National Heart, Lung, and Blood Institute (U.S.) ; Nutrition Surveys* ; Obesity* ; Overweight ; Prevalence ; Spouses ; Stroke ; Thinness ; Surveys and Questionnaires