Contemporary Classifications of Alzheimer’s Disease: A Critical Review of Clinical, Biological, Neuropathological, Functional, Phenotypic and Neuroinformational Frameworks
DOI:
https://doi.org/10.61467/2007.1558.2027.v18i1.1551Keywords:
Alzheimer’s disease, biomarkers, Enfermedad de Alzheimer, biomarcadoresAbstract
Alzheimer’s disease is classified using multiple frameworks that do not always refer to the same construct. These include clinical severity, biological status, neuropathological burden, functional impairment, phenotypic presentation, genetic risk, neuropsychological profile and sensory impairment. This comprehensive critical review examines contemporary frameworks for classifying Alzheimer’s disease and analyses their conceptual scope, methodological utility and principal limitations. The evidence base comprises studies, consensus documents, diagnostic criteria and neuropathological guidelines. The classification systems were organised into seven main categories: clinical and cognitive staging; biomarker-based frameworks; neuropathological classifications; functional scales; phenotypic variants; classifications by age at onset, genetics and risk; and sensory-neuroinformational approaches. The findings indicate that existing frameworks provide complementary yet fragmented perspectives. Clinical systems describe symptoms and severity, biomarker models define the biological status of the disease, neuropathological classifications assess post-mortem lesion burden, functional scales estimate dependency, and phenotypic classifications capture typical and atypical presentations. However, substantial ambiguity remains because these systems often overlap despite not being conceptually equivalent. This review sets out a multidimensional taxonomy intended to clarify what each classification framework measures and how it may be applied in research and clinical interpretation. As an original contribution, sensory neuroinformation is proposed as an emerging classificatory dimension based on latency, fidelity and integration. It may offer a complementary framework for understanding Alzheimer’s disease as a progressive deterioration in sensory-cognitive information processing.
Spanish-language metadata / Metadatos en español
Título en español:
Clasificaciones contemporáneas de la enfermedad de Alzheimer: una revisión crítica de los marcos clínicos, biológicos, neuropatológicos, funcionales, fenotípicos y neuroinformacionales
Resumen:
La enfermedad de Alzheimer se clasifica mediante múltiples marcos que no siempre hacen referencia al mismo constructo. Estos incluyen la gravedad clínica, el estado biológico, la carga neuropatológica, el deterioro funcional, la presentación fenotípica, el riesgo genético, el perfil neuropsicológico y el deterioro sensorial. Esta revisión crítica exhaustiva examina los marcos contemporáneos para la clasificación de la enfermedad de Alzheimer y analiza su alcance conceptual, utilidad metodológica y principales limitaciones.
La base de evidencia comprende estudios, documentos de consenso, criterios diagnósticos y guías neuropatológicas. Los sistemas de clasificación se organizaron en siete categorías principales: estadificación clínica y cognitiva; marcos basados en biomarcadores; clasificaciones neuropatológicas; escalas funcionales; variantes fenotípicas; clasificaciones según la edad de inicio, la genética y el riesgo; y enfoques sensoriales-neuroinformacionales.
Los hallazgos indican que los marcos existentes proporcionan perspectivas complementarias, aunque fragmentadas. Los sistemas clínicos describen los síntomas y su gravedad; los modelos basados en biomarcadores definen el estado biológico de la enfermedad; las clasificaciones neuropatológicas evalúan la carga de lesiones post mortem; las escalas funcionales estiman el grado de dependencia; y las clasificaciones fenotípicas caracterizan las presentaciones típicas y atípicas. Sin embargo, persiste una ambigüedad considerable, ya que estos sistemas suelen solaparse pese a no ser conceptualmente equivalentes.
Esta revisión propone una taxonomía multidimensional destinada a clarificar qué mide cada marco de clasificación y cómo puede aplicarse en la investigación y la interpretación clínica. Como contribución original, se propone la neuroinformación sensorial como una dimensión clasificatoria emergente basada en la latencia, la fidelidad y la integración. Esta podría ofrecer un marco complementario para comprender la enfermedad de Alzheimer como un deterioro progresivo del procesamiento de la información sensorial-cognitiva.
Palabras Claves:
Enfermedad de Alzheimer, biomarcadores.
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