Alzheimer's disease

Alzheimer's disease (AD) is a chronic, progressive neurodegenerative disorder characterised by a global, non-reversible impairment in cerebral functioning.

AD is characterised by memory loss, loss of social and occupational functioning, diminished executive function, speech and motor deficits, personality change, and behavioural 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 behavioural and psychological symptoms.

Psychosocial interventions and carer support are key to managing disease course. Carer support groups are beneficial to carers and should be considered, where available.

Alzheimer's 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 co-exists with other forms of dementia, particularly vascular dementia (mixed-type dementia). The histopathology of AD is characterised by senile plaques, neurofibrillary tangles, and neuronal loss. The hallmark symptoms are memory loss, impairment of daily activities, and neurobehavioural abnormalities. Definition of severity varies according to country, but a commonly accepted categorisation 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.

BMJ talk medicine podcast: Alzheimer's dementia Opens in new window