An ideal biological marker of Alzheimer's disease: dream or reality?

Senile dementia of Alzheimer's type (AD) is commonly characterized as a neurodegenerative disorder, which exhibits gradual changes of consciousness, loss of memory, perception and orientation as well as loss of personality and intellect. AD prevalence increases dramatically with age and is the fourth cause of death in Europe and in the USA. Currently, there are no available biological markers, which gives clinicians no other alternative than to rely upon clinical diagnosis by exclusion. There is no assay of objective ante mortem biochemical phenomena that relate to the pathophysiology of this disease. The pathophysiology of AD is connected with alterations in neurotransmission, plaque formation, cytoskeletal abnormalities and disturbances of calcium homeostasis. The search for a test, which is non-invasive, simple, cheap and user-friendly, should be directed at accessible body fluids. Only abnormalities replicated in large series across different laboratories fulfilling the criteria for a biological marker are likely to be of relevance in diagnosing AD. To date, only the combination of cerebrospinal fluid tau and Abeta42 most closely approximate an ideal biomarker of Alzheimer's disease. A short review on the role of biological markers in AD on the basis of the literature, contemporary knowledge and our own recent findings are presented.