As the global prevalence of neurodegenerative disorders escalates into a defining public health crisis of the twenty-first century, dedicated advocacy and scientific non-governmental institutions have become indispensable pillars of clinical advancement and community support. The Alzheimer’s Association stands as the world’s leading voluntary health organization dedicated to Alzheimer’s disease care, support, and biomedical research. Through its dual mandate of philanthropic scientific funding and grassroots community education, the organization has profoundly transformed global scientific understanding, diagnostic nosology, and compassionate care frameworks for dementia.
Alzheimer’s Association
1. Concise Definition
The Alzheimer’s Association is a non-profit, voluntary health organization headquartered in the United States that operates globally to eliminate Alzheimer’s disease and other dementias through the acceleration of scientific research, risk reduction strategies, early detection frameworks, and quality care provision. Functioning as both a scientific funding consortium and a social welfare advocacy network, it serves as the largest non-governmental funder of dementia research in the world.
Beyond its grant-making mechanisms, the association provides extensive public health education, clinical guidance documents, care navigation systems, and political advocacy at state, federal, and international levels. Through initiatives such as the annual Alzheimer’s Disease Facts and Figures report and clinical diagnostic criteria developed in partnership with governmental bodies, the organization functions as a bridge connecting basic neurobiology, clinical neurology, health economics, and family caregiving.
2. Etymology & Linguistic Origin
The institutional title combines the eponymic medical designation “Alzheimer’s” with the institutional noun “Association.” The term “Alzheimer” derives from the German clinical psychiatrist and neuropathologist Alois Alzheimer (1864–1915), who in 1906 identified the unique pathological hallmarks—subsequently identified as amyloid-beta plaques and neurofibrillary tau tangles—in the post-mortem brain tissue of a 51-year-old patient named Auguste Deter. The possessive form denotes historical attribution to Dr. Alzheimer’s initial clinical documentation of presenile dementia.
The noun “association” originates from the Late Latin associatio (stemming from associare, formed from ad- meaning “to” and sociare meaning “to join together or unite”, rooted in socius, meaning “companion or ally”). Entering Middle English via Old French, the modern civic usage signifies an organized body of people brought together for a shared professional, charitable, or scientific purpose. The organization was formally founded in 1980 under the original corporate designation “Alzheimer’s Disease and Related Disorders Association, Inc.,” which remains its registered legal title, while “Alzheimer’s Association” operates as its primary public-facing moniker.
3. Pronunciation & Grammatical Form
Phonetically transcribed in the International Phonetic Alphabet (IPA), the title is pronounced as /ælts.haɪ.mərz əˌsoʊ.siˈeɪ.ʃən/ in American English and /ælts.haɪ.məz əˌsəʊ.siˈeɪ.ʃn/ in Received Pronunciation British English.
Grammatically, the term functions as a proper noun phrase and compound institutional noun. In syntactic deployment, it takes singular verb agreement (e.g., “The Alzheimer’s Association publishes annual epidemiological data”). It frequently serves as an attributive noun adjunct modifying downstream professional guidelines, clinical programs, and scientific congresses, such as in “Alzheimer’s Association diagnostic frameworks” or “Alzheimer’s Association International Conference.”
4. Detailed Conceptual Explanation
To fully understand the Alzheimer’s Association requires an examination of its multifaceted identity across public health, neurobiology, and socio-political systems. At its conceptual core, the organization addresses the fragmented reality of neurodegenerative illness, wherein biological pathology intersects with psychological distress, economic catastrophe, and systemic healthcare failure. The association reconceptualizes dementia not merely as an inevitable consequence of human aging, but as a pathologically distinct biological disease process that demands systematic empirical investigation, legislative mobilization, and targeted therapeutic intervention.
Structurally, the organization operates a unified matrix model comprising a national headquarters that oversees macro-level research funding, scientific publishing, federal policy lobbying, and global public health initiatives, coupled with dozens of local regional chapters distributed across the United States. These local chapters operationalize the organization’s humanitarian mission through peer-led support groups, localized family counseling, emergency crisis navigation, and clinical trials recruitment support. The organization maintains a continuous, 24/7 bilingual helpline staffed by master’s-level clinicians to provide instantaneous psychosocial triage to caregivers, families, and affected individuals experiencing psychiatric or behavioral crises.
In the academic and scientific realm, the Alzheimer’s Association convenes the Alzheimer’s Association International Conference (AAIC), the largest annual gathering of neuroscientists, geriatricians, and cognitive specialists in the world. Through this platform, emergent clinical trial outcomes, revolutionary molecular imaging tracers, and fluid biomarker discoveries are unveiled to the global scientific community. Furthermore, the organization edits and disseminates high-impact scientific periodicals, most notably Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, which shapes global discourse on neuropathology, biomarkers, and therapeutic trials.
At the macro-societal boundary, the association functions as a nonpartisan political powerhouse. Through its affiliated 501(c)(4) advocacy arm, the Alzheimer’s Impact Movement (AIM), the association lobbies governmental agencies, particularly the United States Congress, the Department of Health and Human Services, and the Food and Drug Administration (FDA). This work has facilitated unprecedented increases in federal biomedical research allocations to the National Institutes of Health (NIH), transforming federal funding levels from several hundred million dollars in the early 2000s to over three billion dollars annually in recent fiscal cycles.
5. Historical Development
The origins of the Alzheimer’s Association emerged from grassroots frustration during an era when late-life cognitive decline was dismissed by medical orthodoxy as mere “senility” or normal aging. In 1979, Jerome H. Stone, a prominent Chicago businessman whose wife Evelyn had been diagnosed with the disease, recognized the total absence of formal community resources, medical consensus, or family guidance. Stone convened a network of family caregivers and visionary biomedical researchers who shared a conviction that dementia was an organic disease process requiring targeted scientific inquiry.
On April 10, 1980, the Alzheimer’s Disease and Related Disorders Association was officially founded by Jerome Stone and representatives from several independent family support groups, including leaders such as Bobbie Glaze and Hilda Pridgeon, alongside pioneering physician-researchers like Dr. Robert Katzman. Katzman’s seminal 1976 editorial, “The Prevalence and Malignancy of Alzheimer Disease,” had articulated that Alzheimer’s was a primary killer of the elderly rather than an innocuous byproduct of chronological senescence, providing the intellectual scaffolding for the newly formed non-profit.
Throughout the 1980s, the organization expanded rapidly, launching its initial research grants program in 1982 with an initial distribution of less than one hundred thousand dollars. In 1984, the association collaborated with the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) to produce the historic NINCDS-ADRDA consensus criteria, which established the standardized clinical phenotype for “probable Alzheimer’s disease” that governed clinical practice and randomized clinical trials for nearly three decades.
The 1990s and 2000s marked an era of rapid operational maturation and legislative influence. The association introduced the 24/7 Helpline, launched its flagship awareness fundraising initiative, the “Memory Walk” (later rebranded as the “Walk to End Alzheimer’s”), and significantly elevated public consciousness through campaigns featuring prominent public figures such as former U.S. President Ronald Reagan, who revealed his personal diagnosis in an open letter to the American public in 1994. In 2011, the association achieved a landmark public policy victory by driving the unanimous congressional passage of the National Alzheimer’s Project Act (NAPA), which mandated a comprehensive national strategic plan to prevent and treat Alzheimer’s disease.
6. Theoretical Foundations
The institutional and scientific strategies of the Alzheimer’s Association are anchored in several foundational biomedical and psychosocial theories that have evolved over the past four decades:
In neurobiology, the association’s funding architecture was long aligned with the Amyloid Cascade Hypothesis, first articulated by John Hardy and David Higgins in 1991. This model postulates that the pathological deposition of extracellular amyloid-beta peptides triggers a deleterious sequence of neurofibrillary tau tangling, neuroinflammation, synaptotoxicity, and massive neuronal apoptosis. While maintaining significant investment in anti-amyloid therapeutics, the association’s theoretical paradigm has expanded to embrace the “multifactorial etiology framework,” which conceptualizes dementia as an intricate convergence of neurovascular dysfunction, innate immune system dysregulation (microglial activation), metabolic impairment, and genetic susceptibility factors such as the Apolipoprotein E (APOE) epsilon 4 allele.
In diagnostic nosology, the organization championed the transition from a purely syndromic clinical construct to a strictly biological definition of Alzheimer’s disease. Working in close collaboration with the National Institute on Aging (NIA), the association introduced the NIA-AA Research Framework in 2018. This framework conceptualizes the illness along an uninterrupted biological continuum defined by the “ATN” biomarker classification system: “A” representing aggregated amyloid biomarkers (amyloid-PET or cerebrospinal fluid [CSF] / plasma Aβ42/40 ratio), “T” representing fibrillar tau markers (tau-PET or phosphorylated tau species like p-tau181, p-tau217), and “N” reflecting generalized neurodegeneration (fluorodeoxyglucose-PET, structural MRI cortical atrophy, or neurofilament light chain [NfL]). This biological paradigm decouples the biological disease state from clinical symptom presentation, establishing that the disease begins decades before visible cognitive impairment manifests.
Psychosocially, the association’s support programs are grounded in person-centered dementia care theory, originally advanced by British social psychologist Tom Kitwood. Kitwood challenged the purely mechanistic medical model by demonstrating that an individual’s cognitive and psychological well-being is heavily mediated by interpersonal interactions, subjective social environments, and relational validation. This psychosocial framework asserts that psychological personhood remains preserved despite profound cognitive deficits, necessitating individualized care approaches, non-pharmacological behavioral modifications, and caregiver empowerment models.
7. Key Components, Types & Dimensions
The programmatic operations, clinical resources, and strategic branches of the Alzheimer’s Association can be classified into several primary dimensions:
- Scientific Grant Programs and Investigator Funding: Peer-reviewed scientific funding mechanisms that distribute capital to pre-doctoral, postdoctoral, and senior research investigators worldwide. Programs include the International Research Grant Program (IRGP), the Clinician Scientist Fellowship, and targeted awards focusing on diverse populations and innovative non-amyloid therapeutic targets.
- Direct Care and Family Support Services: Psychosocial infrastructure including the toll-free, continuous 24/7 Helpline (1-800-272-3900), standardized local family support groups, structured care consultations led by licensed clinical social workers, and the digital care-navigation software “ALZConnected,” an online social forum for patients and family caregivers.
- Clinical and Diagnostic Nosology Working Groups: Formal expert consensus panels convened alongside international scientific bodies to author, refine, and disseminate updated diagnostic guidelines, staging criteria, and standardized outcome measures for use in clinical settings and clinical trial design.
- Public Policy and Legislative Mobilization (AIM): The political apparatus that recruits citizen advocates across congressional districts to lobby for federal research appropriations, equitable Medicare/Medicaid diagnostic coverage, specialized long-term care staffing ratios, and public health infrastructure investments.
- Global Scientific Dissemination Platforms: Dissemination networks anchored by the annual Alzheimer’s Association International Conference (AAIC), the global professional network known as the International Society to Advance Alzheimer’s Research and Treatment (ISTAART), and the high-impact academic journal portfolio led by Alzheimer’s & Dementia.
- Epidemiological Surveillance and Public Awareness: Annual publication of the comprehensive Facts and Figures report, which provides peer-reviewed statistical updates regarding domestic disease prevalence, caregiver burden, racial disparities, and national economic impact, alongside national fundraising initiatives such as the Walk to End Alzheimer’s and The Longest Day.
8. Examples & Illustrative Cases
The systemic impact of the Alzheimer’s Association can be illustrated through both macroscopic institutional initiatives and individual clinical vignettes.
Case Illustration 1: Macro-Level Biomarker Translation (The IDEAS Study)
In 2016, following the FDA approval of specialized positron emission tomography (PET) tracers capable of imaging amyloid plaques in living brains, the Centers for Medicare & Medicaid Services (CMS) declined national Medicare coverage for these scans, citing an absence of prospective empirical evidence demonstrating that visualization of amyloid plaques actually altered clinical management and improved downstream clinical outcomes. In response, the Alzheimer’s Association sponsored and led the landmark Imaging Dementia—Evidence for Amyloid Scanning (IDEAS) study, enrolling over 18,000 Medicare beneficiaries across hundreds of clinical sites. The results published by Rabinovici and colleagues demonstrated that access to amyloid PET scans directly led physicians to alter medical management in more than 60% of cases, providing the crucial empirical justification that ultimately pressured regulatory agencies to modernize reimbursement protocols for advanced neuroimaging diagnostics.
Case Illustration 2: Grassroots Psychosocial Care Navigation
Consider a 62-year-old corporate accountant, “Patient M,” who began presenting with insidious deficits in working memory, executive dysfunction, and subtle behavioral changes. Following clinical evaluation, Patient M was diagnosed with early-onset Alzheimer’s disease. Confronted by this devastating medical verdict, Patient M’s spouse contacted the association’s 24/7 Helpline in acute emotional distress. Through immediate care consultation, the spouse was connected with a localized younger-onset support group, received specialized legal and financial planning documentation, and gained access to trial matching through the association’s “TrialMatch” registry. Patient M subsequently enrolled in an early-stage clinical trial evaluating novel monoclonal antibodies, while the spouse acquired non-pharmacological behavioral management strategies that substantially mitigated caregiver strain, preventing premature institutional nursing home placement.
9. Measurement & Assessment
While the Alzheimer’s Association is an organization rather than a diagnostic psychometric instrument, it plays an active role in establishing, validating, and disseminating standard cognitive assessment instruments, screening regimens, and clinical outcome metrics used throughout modern medicine.
In outpatient primary care environments, the association’s clinical workgroups formulated formal recommendations for cognitive assessment within the Medicare Annual Wellness Visit. The association rigorously reviewed brief cognitive screening instruments, endorsing standardized clinical tools with robust psychometric profiles such as the Montreal Cognitive Assessment (MoCA), the Mini-Cog, and the General Practitioner Assessment of Cognition (GPCOG) for frontline clinical identification of mild cognitive impairment (MCI).
For clinical trial design and longitudinal research studies, the association advocates for composite psychometric scores that capture early, subtle changes in high-functioning cohorts. These include the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) and the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB), the latter serving as the gold-standard primary efficacy endpoint in modern phase 3 registration trials for disease-modifying immunotherapies.
On an institutional and programmatic level, the association evaluates the efficacy of its own nationwide community programs using rigorously validated psychometric measures of caregiver burden, such as the Zarit Burden Interview (ZBI) and specialized self-efficacy inventories. These instruments verify whether caregiver participation in psychoeducational workshops reliably yields reductions in chronic stress, depression, and social isolation.
10. Applications & Practical Significance
The applied utility of the Alzheimer’s Association spans healthcare systems, scientific laboratories, regulatory agencies, and everyday domestic caregiving:
In Healthcare Systems and Clinical Practice: The organization’s evidence-based clinical guidelines guide the diagnostic workflow of neurologists, geriatricians, and primary care physicians worldwide. Its clinical consensus statements delineate how and when to deploy novel blood-based biomarkers (such as plasma phosphorylated-tau assays), how to navigate ethical disclosure of genetic risk profiles (e.g., APOE testing), and how to safely monitor patients on newly approved anti-amyloid monoclonal antibodies (such as lecanemab and donanemab) for adverse events like Amyloid-Related Imaging Abnormalities (ARIA).
In Care Settings and Long-Term Residential Facilities: Through its Dementia Care Practice Recommendations, the association establishes clinical standards for assisted living and skilled nursing facilities. These recommendations focus on person-centered principles, demonstrating that non-pharmacological interventions directed at unmet psychological needs should serve as the absolute first-line approach for managing behavioral and psychological symptoms of dementia (BPSD), actively discouraging the hazardous off-label overutilization of atypical antipsychotics.
In Public Health and Legislative Strategy: By compiling the annual Facts and Figures report, the association provides essential longitudinal data that enables health economists, state health departments, and governmental bodies to model future fiscal liabilities, project long-term care bed capacity needs, and direct public resources toward populations facing heightened risk, such as African American and Hispanic communities who experience disproportionately elevated rates of vascular and neurodegenerative cognitive decline.
11. Research & Empirical Evidence
The Alzheimer’s Association is widely recognized as an engine of modern dementia neuroscience. Empirical data tracking its grant investments show that the association has committed more than $400 million across thousands of active scientific research projects internationally, catalyzing investigations that often lack preliminary data for larger NIH R01 funding.
A critical illustration of association-driven research is the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER), modeled directly after the groundbreaking Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). U.S. POINTER represents a landmark two-year clinical trial evaluating whether multi-domain lifestyle interventions—integrating physical exercise, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) nutritional regimen, intellectual cognitive challenge, and rigorous vascular risk monitoring—can protect cognitive reserve in older adults at heightened biological risk for decline. The resulting evidence reinforces that non-pharmacological systemic lifestyle modifications exert potent, biologically meaningful effects on neurological preservation.
Furthermore, through its peer-reviewed scientific journals, the association regularly publishes empirical data on clinical trial methodologies. Seminal publications coordinated by association workgroups have established standardized frameworks for diagnosing mixed dementias, delineating the boundaries of Primary Progressive Aphasia (PPA), and articulating the diagnostic criteria for Frontotemporal Lobar Degeneration (FTLD) and Dementia with Lewy Bodies (DLB), cementing the organization’s role as a major catalyst for scientific consensus.
12. Cultural & Cross-Cultural Considerations
The presentation, diagnosis, and socio-emotional experience of dementia vary widely across racial, ethnic, and cultural boundaries. A core operational priority of the modern Alzheimer’s Association involves addressing entrenched disparities in healthcare delivery, clinical research recruitment, and cultural stigma.
Epidemiological data gathered by the association emphasize that in the United States, African Americans are approximately twice as likely, and Hispanic/Latino populations are approximately 1.5 times as likely, to develop Alzheimer’s or other dementias compared to non-Hispanic white cohorts. These disparities are rooted primarily in structural social determinants of health, including elevated burdens of chronic cardiovascular conditions, socioeconomic disparities, and systemic discrimination. Despite this elevated prevalence, these communities have historically been starkly underrepresented in biomedical clinical trials, comprising frequently less than 5% of trial cohorts for landmark therapeutic agents.
To mitigate this systemic inequity, the association has adapted its outreach models. In many culturally traditional communities, progressive cognitive decline carries deep stigma, frequently misconstrued as an acute mental illness, spiritual retribution, or a private family matter that should not be discussed outside the household. The association collaborates directly with faith-based organizations, community centers, and historically Black colleges and universities (HBCUs) to deliver linguistically nuanced and culturally resonant educational programming. Additionally, through dedicated grant programs, the association specifically funds investigators conducting research on diverse cohorts, prioritizing the establishment of norm-referenced neuropsychological tests and biomarker cutoffs validated across multi-ethnic populations.
13. Criticisms, Debates & Limitations
Despite its vast contributions, the Alzheimer’s Association has been the subject of ongoing scrutiny and debate across academic, bioethical, and public health spheres.
Pharmaceutical Industry Ties and Financial Conflicts: A recurring critique centers on corporate financial contributions accepted from commercial biotechnology and pharmaceutical manufacturers. Bioethicists have raised concerns regarding whether high-profile corporate funding might subtly compromise the organization’s perceived objectivity. This debate reached national prominence during the FDA approval and subsequent CMS coverage deliberations for novel monoclonal antibodies targeting amyloid, such as aducanumab and lecanemab. The association forcefully lobbied for broad, unrestricted Medicare reimbursement, arguing that patients have a right to access FDA-approved therapeutics. Critics, including public health analysts and independent neurologists, contended that the association advocated too aggressively for compounds with marginal clinical efficacy and high safety risks (such as cerebral microhemorrhages and localized brain edema associated with ARIA), aligning closely with the commercial objectives of pharmaceutical manufacturers.
Prolonged Amyloid Centricity: Within the academic neurobiology community, some scientists have criticized the association for historically directing an excessive proportion of research funding toward the amyloid cascade hypothesis at the expense of alternative therapeutic paradigms. Critics have argued that the decades-long focus on clearing amyloid plaques diverted capital away from crucial pathways, including infectious pathogen triggers, metabolic/insulin resistance cascades, mitochondrial failure, and innate neuroinflammatory biology.
Biological vs. Clinical Diagnostic Definitions: The introduction of the 2018 NIA-AA Research Framework, which defined Alzheimer’s disease strictly as a biological construct determined by biomarkers (ATN) regardless of clinical symptoms, ignited intense clinical debate. Prominent neuropsychologists and geriatricians expressed concern that labeling cognitively intact individuals as “having Alzheimer’s disease” simply due to anomalous biomarker scans introduces profound existential dread, social stigma, and employment complications without a guaranteed trajectory toward overt clinical dementia during their natural lifespan.
14. Related Terms & Distinctions
To prevent conceptual confusion, the Alzheimer’s Association must be carefully distinguished from related organizational bodies, medical conditions, and scientific constructs:
- Alzheimer’s Disease vs. Dementia: Dementia is an overarching clinical umbrella term describing a progressive syndrome characterized by cognitive decline severe enough to impair independent daily functioning. Alzheimer’s disease is a specific, underlying neurodegenerative pathology that accounts for 60% to 80% of all dementia cases. The Alzheimer’s Association addresses the entire spectrum of dementias, not exclusively Alzheimer’s disease.
- Alzheimer’s Association vs. National Institute on Aging (NIA): The NIA is an official governmental research branch of the U.S. National Institutes of Health (NIH) funded directly by taxpayer dollars through congressional appropriations. The Alzheimer’s Association is an independent, non-governmental 501(c)(3) voluntary health organization that operates via private philanthropic donations, corporate sponsorships, and public fundraising. The two entities often partner (e.g., NIA-AA criteria) but operate completely independently.
- Alzheimer’s Association vs. Alzheimer’s Disease International (ADI): ADI is an international federation of hundreds of independent national Alzheimer’s associations across the world, maintaining official relations with the World Health Organization (WHO). The Alzheimer’s Association is the United States member organization of ADI, though it frequently operates its own global research funding and scientific conferences independently due to its vast capital resources.
- Alzheimer’s Impact Movement (AIM) vs. Alzheimer’s Association: While intrinsically linked, the Alzheimer’s Association is a charitable 501(c)(3) nonprofit barred by federal law from direct candidate endorsements and certain lobbying restrictions. AIM is a distinct 501(c)(4) sister advocacy organization established specifically to navigate political lobbying and legislative intervention.
15. Summary / Key Takeaways
The Alzheimer’s Association has transformed from a localized, family-driven support network formed in 1980 into an international driver of neuroscience, clinical guidance, and health policy. By funding innovative research grants, publishing foundational scientific literature, and organizing the world’s premier scientific congresses, the association has catalyzed transformative milestones in dementia research. Concurrently, its grassroots community networks provide care navigation, crisis triage, and psychoeducational guidance to millions of caregivers and families navigating cognitive impairment. While navigations surrounding biomarker-based diagnostic definitions and pharmaceutical relationships remain active topics of debate, the association continues to define the forefront of clinical research, diagnostic standardization, and public advocacy in the ongoing fight against neurodegenerative decline.
References
- Alzheimer’s Association. (2023). 2023 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 19(4), 1598–1695. https://doi.org/10.1002/alz.13016
- Hardy, J., & Higgins, G. (1991). Alzheimer’s disease: The amyloid cascade hypothesis. Science, 256(5054), 184–185. https://doi.org/10.1126/science.1566067
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- Katzman, R. (1976). The prevalence and malignancy of Alzheimer disease: A major killer. Archives of Neurology, 33(4), 217–218. https://doi.org/10.1001/archneur.1976.00500040001001
- Kitwood, T. (1997). Dementia reconsidered: The person comes first. Open University Press.
- McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34(7), 939–944. https://doi.org/10.1212/wnl.34.7.939
- Rabinovici, G. D., Gatsonis, C., Apgar, C., Chaudhary, K., Gareen, I., Hanna, L., Hendrix, J., Hillner, B. E., Olson, C., Lesman-Segev, O. H., Romanoff, J., Siegel, B. A., Whitmer, R. A., & Carrillo, M. C. (2019). Association of amyloid positron emission tomography with subsequent change in clinical management among Medicare beneficiaries with mild cognitive impairment or dementia: The IDEAS study. JAMA, 321(13), 1286–1294. https://doi.org/10.1001/jama.2019.2465