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    Alzheimer's Disease Can Have Long Prodromal Phase

    Signs of cognitive decline appear up to 12 years before onset of dementia

    MONDAY, Dec. 15 (HealthDay News) -- Patients with Alzheimer's disease develop symptoms of cognitive decline as early as 12 years before the onset of dementia, according to an article published online Dec. 9 in the Annals of Neurology.

    Helene Amieva, Ph.D., of the Institut National de la Sante et de la Recherche Medicale in Bordeaux, France, and colleagues conducted a study of 350 subjects with Alzheimer's disease matched with 350 elderly controls; both samples were selected from a cohort of 3,777 initial subjects and matched after 14 years of follow-up.

    Twelve years before onset of dementia, subjects in the Alzheimer's disease group showed signs of cognitive decline, followed by a period of greater global deficits as well as more complaints about memory loss and depression, the investigators found. Slight dependence in daily activities began to occur two years later, and the last three years before onset of dementia were marked by a significant worsening of symptoms, the researchers report.

    "This unique set of observations may help to generate hypotheses regarding the clinical exteriorization of the Alzheimer's disease pathological process," the authors write. "If a biomarker becomes reliable enough to allow the detection of underlying Alzheimer's disease pathology in subjects who are screened on neuropsychological tests but are still 'asymptomatic' or symptomatic and not yet demented, there might be enough time to influence the later course of the disease with new disease-modifying treatments that are being developed."

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