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Abstract :
[en] Considering that brain pathology due to Alzheimer’s disease starts many years before the clinical symptoms become evident, subtle cognitive changes may exist already in the predementia phase. Different approaches have been used to detect initial cognitive impairments indicative of Alzheimer’s disease. One approach is the assessment of the predictive power of neuropsychological tools in characterizing patients with stable mild cognitive impairment (MCI) versus MCI patients who subsequently develop Alzheimer’s disease. Another approach is the longitudinal evaluation of large cohorts of older adults in population-based studies. Findings from several studies suggest that a memory test that ensures deep encoding of information and assesses retrieval with free as well as cued recall is a useful tool to distinguish patients at an early stage of Alzheimer disease from MCI non-converters. Impaired semantic memory has also been proposed as a neuropsychological marker of predementia Alzheimer’s disease. Beyond the memory domain, category verbal fluency has been shown to predict progression to Alzheimer’s disease. Moreover, combining neuropsychological scores of memory and executive functions and neuroimaging data allows a better discrimination between stable MCI and converters than neuroimaging data alone. Altogether, it is possible to detect cognitive changes that are predictive of the typical form of probable Alzheimer’s disease already in the predementia stage. Such at risk people are thought to be the best target for therapeutic interventions.