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Alzheimer disease

Última revisão: 22 Jul 2025
Última atualização: 20 Aug 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • memory loss
  • disorientation
  • nominal dysphasia
  • misplacing items/getting lost
  • apathy
  • decline in activities of daily living and instrumental activities of daily living (IADLs)
  • personality change
  • unremarkable initial physical exam
Detalhes completos

Outros fatores diagnósticos

  • mood and behavior changes
  • poor abstract thinking
  • constructional dyspraxia
  • prosopagnosia
  • autoprosopagnosia
Detalhes completos

Fatores de risco

  • advanced age
  • family history
  • genetics
  • Down syndrome
  • cerebrovascular disease
  • lifestyle factors and environment
  • use of certain drugs
  • less than high school education
  • traumatic brain injury
  • depression
  • hearing loss
  • periodontal disease
  • visual impairment
  • herpes simplex virus type 1 (HSV-1) infection
  • hyperlipidemia
  • female sex
  • elevated plasma homocysteine level
  • surgery under general anesthesia
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • cognitive testing
  • CBC
  • metabolic panel
  • serum thyroid-stimulating hormone (TSH)
  • serum vitamin B12
  • urine drug screen
  • CT brain (without contrast)
  • MRI brain (without contrast)
Detalhes completos

Investigações a serem consideradas

  • cerebrospinal fluid (CSF) analysis
  • serum rapid plasma reagin/Venereal Disease Research Laboratory (VDRL)
  • serum HIV testing
  • formal neuropsychological testing
  • genetic testing
  • fluorodeoxyglucose-PET (FDG-PET)
  • CSF biomarker testing
Detalhes completos

Novos exames

  • amyloid-PET
  • blood biomarkers

Algoritmo de tratamento

CONTÍNUA

all patients

Colaboradores

Autores

Judith Neugroschl, MD

Associate Professor of Psychiatry

Alzheimer's Disease Research Center

Icahn School of Medicine at Mount Sinai

New York

NY

Declarações

JN participates in research funded by National Institutes for Health (NIH) grants. The Alzheimer's Disease Research Center is a site for clinical research but JN is not the site Principal Investigator, has no role in purchasing nor choosing the studies, and gains no compensation if it succeeds. JN helps to edit the Focus on Healthy Aging Alzheimer's yearly report.

Agradecimentos

Dr Judith Neugroschl would like to gratefully acknowledge Dr Brandy R. Matthews, Dr Asif S. Bhutto, and Dr Julie K. Gammack, the previous contributors to this topic.

Declarações

BRM, ASB, and JKG declare that they have no competing interests.

Revisores

Roy J. Goldberg, MD, FACP, AGSF, CMD

Medical Director

Kings Harbor Multicare Center

New York

NY

Declarações

RJG declares that he has no competing interests.

Philip Scheltens, MD, PhD

Professor of Neurology

Department of Neurology/Alzheimer Center

VU University Medical Center

Amsterdam

The Netherlands

Declarações

PS declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing commission. Lancet. 2024 Aug 10;404(10452):572-628. Resumo

American College of Radiology. ACR appropriateness criteria: dementia. 2024 [internet publication].Texto completo

McShane R, Westby MJ, Roberts E, et al. Memantine for dementia. Cochrane Database Syst Rev. 2019 Mar 20;(3):CD003154.Texto completo  Resumo

Birks JS, Chong LY, Grimley Evans J. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015 Sep 22;(9):CD001191.Texto completo  Resumo

Birks JS, Harvey RJ. Donepezil for dementia due to Alzheimer's disease. Cochrane Database Syst Rev. 2018 Jun 18;(6):CD001190.Texto completo  Resumo

Reus VI, Fochtmann LJ, Eyler AE, et al. The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementia. Am J Psychiatry. 2016 May 1;173(5):543-6.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diretrizes

    • ACR appropriateness criteria: dementia
    • European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Alzheimer disease and other kinds of dementia

    Caring for someone with dementia

    Mais Folhetos informativos para os pacientes
  • Calculadoras

    Geriatric Depression Scale

    Mais Calculadoras
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