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Doença de Alzheimer

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Last reviewed: 21 Jul 2025
Last updated: 05 Sep 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • perda de memória
  • desorientação
  • disfasia nominal
  • colocar itens no lugar errado/se perder
  • apatia
  • declínio das atividades da vida diária e atividades instrumentais da vida diária (AIVDs)
  • alteração de personalidade
  • exame físico inicial normal
Full details

Other diagnostic factors

  • alterações no humor
  • má qualidade do pensamento abstrato
  • dispraxia construtiva
  • prosopagnosia
  • autoprosopagnosia
Full details

Risk factors

  • idade avançada
  • história familiar
  • genética
  • Síndrome de Down
  • doença cerebrovascular
  • fatores de estilo de vida e medicamentos
  • Escolaridade inferior ao ensino secundário
  • lesão cerebral traumática
  • depressão
  • perda auditiva
  • hiperlipidemia
  • sexo feminino
  • nível elevado de homocisteína no plasma
  • consumo de refrigerantes adoçados artificialmente
Full details

Diagnostic investigations

1st investigations to order

  • testes cognitivos à beira do leito
  • Hemograma completo
  • perfil metabólico
  • hormônio estimulante da tireoide (TSH) sérico
  • vitamina B12 sérica
  • exame de urina para detecção de drogas
  • tomografia computadorizada (TC)
  • RNM
Full details

Investigations to consider

  • Análise do líquido cefalorraquidiano (LCR)
  • reagina plasmática rápida/teste Venereal Disease Research Laboratory (VDRL) séricos
  • vírus da imunodeficiência humana (HIV) sérico
  • testes neuropsicológicos formais
  • teste genético
  • PET com fluordeoxiglicose (FDG-PET)
  • TC por emissão de fóton único (SPECT)
  • eletroencefalograma (EEG)
Full details

Emerging tests

  • tomografia por emissão de pósitrons (PET) do amiloide

Treatment algorithm

ONGOING

todos os pacientes

Contributors

Authors

Judith Neugroschl, MD

Associate Professor of Psychiatry

Alzheimer's Disease Research Center

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

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 they succeed. JN helps to edit the Focus on Healthy Aging Alzheimer's yearly report.

Acknowledgements

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.

Disclosures

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

Peer reviewers

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

Medical Director

Kings Harbor Multicare Center

New York

NY

Disclosures

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

Disclosures

PS declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 Jan;18(1):88-106.Full text  Abstract

Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-46.Full text  Abstract

Fink HA, Linskens EJ, Silverman PC, et al. Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia. Ann Intern Med. 2020 May 19;172(10):669-77. Abstract

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

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

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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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