AD (Alzheimer's disease)
Alzheimer's disease is a progressive degenerative disease of the brain causing 50% of the dementia seen in western society. Its cause is unknown.
It may be defined as a clinicopathological entity where there are histological changes of neurofibrillary tangles and senile plaques in a patient with dementia.
An informative history is therefore very important.
- Alzheimer's disease
is usually insidious in onset and develops slowly but steadily over a period of
- affects predominantly the elderly
- progression is characterised by deterioration in cognition (thinking, conceiving, reasoning) and functional ability (activities of daily living) and a disturbance in behaviour and mood
- evidence suggests that Alzheimer's disease progression is dependent on age, and the time from diagnosis to death is about 5-20 years (median 5 years in people aged 75-80 years)
- people with Alzheimer's disease lose the ability to carry out routine daily activities like dressing, toileting, travelling and handling money and, as a result, many of them require a high level of care
- non-cognitive symptoms in dementia include agitation, behavioural disturbances (for example, wandering or aggression), depression, delusions and hallucinations.
Mental State Examination (MMSE - 30 points) can be used to classify the severity of cognitive impairment in Alzheimer's disease
- mild Alzheimer's disease: MMSE 21 to 26
- moderate Alzheimer's disease: MMSE 10 to 20
- moderately severe Alzheimer's disease: MMSE 10 to 14
- severe Alzheimer's disease: MMSE less than 10
The diagnosis requires confirmation at post-mortem, although in practise it is made on clinical grounds.
- NICE (September 2007).Donepezil, galantamine, rivastigmine (review) and memantine for the treatment of Alzheimer's disease (amended).
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- Sherrington, R et al.. Cloning of a gene bearing missense mutations in early-onset familial Alzheimer's disease. Nature 1995;375: 754-760.
- Selkoe, DJ. News & Views. Nature 1995; 375;734-735.
Last reviewed 05/2021