Alzheimer disease

Alzheimer disease (AD) is a chronic, progressive neurodegenerative disorder characterized by a global, nonreversible impairment in cerebral functioning.

AD is characterized by memory loss, loss of social and occupational functioning, diminished executive function, speech and motor deficits, personality change, and behavioral and psychological disturbance.

It has a deteriorating course over up to 8-10 years.

Brain lesions are marked by neurofibrillary tangles, senile plaques, neuronal loss, and brain atrophy, with defects in acetylcholine synthesis at the cellular level.

Treatment requires a multidisciplinary approach with increasing emphasis on treating behavioral and psychological symptoms. Cholinesterase inhibitors and memantine have some evidence of efficacy in treating the symptoms of the disease. Emerging treatments include monoclonal antibodies that target amyloid-beta, with the aim of slowing decline in cognition and function.

Psychosocial interventions and caregiver support are key. Caregiver support groups are beneficial to caregivers and should be considered, where available.

Alzheimer disease (AD) is a chronic neurodegenerative disease with an insidious onset and progressive but slow decline. AD is the most common type of dementia.[1]Grossman H, Bergmann C, Parker S. Dementia: a brief review. Mt Sinai J Med. 2006 Nov;73(7):985-92. http://www.ncbi.nlm.nih.gov/pubmed/17195884?tool=bestpractice.com [2]Hebert LE, Scherr PA, Bienias JL, et al. Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol. 2003 Aug;60(8):1119-22. http://jamanetwork.com/journals/jamaneurology/fullarticle/784558 http://www.ncbi.nlm.nih.gov/pubmed/12925369?tool=bestpractice.com It often coexists with other forms of dementia, particularly vascular dementia (mixed-type dementia). The histopathology of AD is characterized by senile plaques, neurofibrillary tangles, and neuronal loss. The hallmark symptoms are memory loss, impairment of daily activities, and neurobehavioral abnormalities. Definition of severity varies according to country, but a commonly accepted categorization is mild, moderate, and severe. The Mini-Mental State Examination can be used as a guide to cognitive impairment, but education, language, and any other relevant factors must be taken into consideration when interpreting scores.​