The Current Issue in Clinical Neuropsychology: Cognitive Markers of Dementia with Alzheimer’s Disease

Mau-Sun Hua, Ph.D.

In clinical settings, there are three-level health cares (primary, secondary and tertiary). For physical illness, medical professionals, particularly physicians have been well aware of the importance of primary and secondary cares other than the tertiary one, and actually devoted to those related practices, especially the secondary-care activities (i.e., the early detection and intervention). Accordingly, the term of “biomarkers” has been coined to indicate those components or precursors of biologically pathological features which can be candidates predicting the development of a specific physical disease. For instance, the diagnostic benchmark of Alzheimer’s disease (AD) mainly includes neurofibrillary tangles and amyloid plaques. Amyloid beta-42 (Aβ-42) is one of the components of amyloid plaques and currently has been taken as one of the biomarkers for AD or dementia due to this disease.

The issue of whether or not there are specific neuropsychological dysfunctions evident at the prodromal stage of AD, such as amnestic mild cognitive impairment (aMCI), or even earlier than the aMCI stage, and those impairments can be qualified as candidates of “cognitive markers” parallel to the concept of “biomarkers” for AD, however, remains unsettled. Considering clinical implications of the issue for both preventive medical cares, our clinical research team has been interested in and highlighted this subject. Recently, we preliminarily identified two impaired neurocognitive functions, poor prospective memory (Hsu, Huang, Tu & Hua, 2014) and formation of arbitrarily-associated memory (Cheng, Chen, Cheng, Lai & Hua, 2017), that might be candidates of cognitive markers for the disease or the disease-induced dementia.