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Alzheimer's disease - Highlights

Description

An in-depth report on the causes, diagnosis, and treatment of Alzheimer's disease.

Alternative Names

Highlights:

Alzheimer� ' s Disease

Dementia is significant loss of cognitive functions such as memory, judgment, attention, and abstract thinking. Alzheimer� ' s, the most common form of dementia, is a progressive brain disease. It affects 5 million Americans, and millions more worldwide.

Risk Factors

Age is the greatest risk factor for Alzheimer� ' s disease. Most people who develop Alzheimer� ' s disease are 65 years old or older, and the risk increases with age. People age 85 years and older are especially at risk for Alzheimer� ' s disease.

Symptoms

Early symptoms of Alzheimer's disease may include:

Forgetfulness
Loss of concentration
Language problems
Confusion about time and place
Impaired judgment
Loss of insight
Impaired movement and coordination
Mood and behavior changes
Apathy and depression

Treatment

There is no cure for Alzheimer� ' s disease. Drug therapy aims to slow disease progression and treat symptoms associated with the disease. Clinical studies indicate that these drugs generally have only modest benefit.

Patients and their families need to discuss with their doctors whether drug therapy can help improve behavior or functional abilities. They also need to discuss whether or not drugs should be prescribed early in the course of the disease or delayed.

The following drugs are commonly prescribed for treatment of Alzheimer� ' s disease:

Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Razadyne)
Memantine (Namenda)

Resources

www.nia.nih.gov/alzheimers -- Alzheimer's Disease Education and Referral Center (U.S. National Institute on Aging)
www.alz.org -- Alzheimer's Association
www.alzfdn.org -- Alzheimer's Foundation of America
www.alz.co.uk -- Alzheimer's Disease International
www.ninds.nih.gov -- National Institute of Neurological Disorders and Stroke
www.aan.com -- American Academy of Neurology
www.medicalert.org -- Medic Alert
www.clinicaltrials.gov -- Find clinical trials
www.medicare.gov/NHCompare/Home.asp -- Find a nursing home

References

ADAPT Research Group, Lyketsos CG, Breitner JC, Green RC, Martin BK, Meinert C, et al. Naproxen and celecoxib do not prevent AD in early results from a randomized controlled trial. Neurology. 2007 May 22;68(21):1800-8. Epub 2007 Apr 25.

Aisen PS, Schneider LS, Sano M, Diaz-Arrastia R, van Dyck CH, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease: a randomized controlled trial. JAMA. 2008 Oct 15;300(15):1774-83.

Akomolafe A, Beiser A, Meigs JB, Au R, Green RC, Farrer LA, et al. Diabetes mellitus and risk of developing Alzheimer disease: results from the Framingham Study. Arch Neurol. 2006 Nov;63(11):1551-5.

Alzheimer's Association. 2009 Alzheimer's disease facts and figures. Alzheimers Dement. 2009 May;5(3):234-70.

Ayalon L, Gum AM, Feliciano L, Arean PA. Effectiveness of nonpharmacological interventions for the management of neuropsychiatric symptoms in patients with dementia: a systematic review. Arch Intern Med. 2006 Nov 13;166(20):2182-8.

Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003120.

Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009 Feb 5;338:b158. doi: 10.1136/bmj.b158.

Burns A, Bernabei R, Bullock R, Cruz Jentoft AJ, Frolich L, Hock C, et al. Safety and efficacy of galantamine (Reminyl) in severe Alzheimer's disease (the SERAD study): a randomised, placebo-controlled, double-blind trial. Lancet Neurol. 2009 Jan; 8(1): 39-47.

DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, Saxton JA, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008 Nov 19;300(19):2253-62.

Durga J, van Boxtel MP, Schouten EG, Kok FJ, Jolles J, Katan MB, et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007 Jan 20;369(9557):208-16.

Farlow MR, Cummings JL. Effective pharmacologic management of Alzheimer's disease. Am J Med. 2007 May;120(5):388-97.

Fleisher AS, Sun S, Taylor C, Ward CP, Gamst AC, Petersen RC, et al. Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment. Neurology. 2008 Jan 15; 70(3):191-9.

Isaac MG, Quinn R, Tabet N. Vitamin E for Alzheimer's disease and mild cognitive impairment. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD002854.

Knopfman DS. Alzheimer's disease and other dementias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 425.

Lautenschlager NT, Cox KL, Flicker L, Foster JK, van Bockxmeer FM, Xiao J, et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA. 2008 Sep 3;300(9):1027-37.

Mittelman MS, Haley WE, Clay OJ, Roth DL. Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology. 2006 Nov 14;67(9):1592-9.

Morris MC, Evans DA, Tangney CC, Bienias JL, Wilson RS. Associations of vegetable and fruit consumption with age-related cognitive change. Neurology. 2006 Oct 24;67(8):1370-6.

Regan C, Katona C, Walker Z, Hooper J, Donovan J, Livingston G. Relationship of vascular risk to the progression of Alzheimer disease. Neurology. 2006 Oct 24;67(8):1357-62.

Scarmeas N, Stern Y, Mayeux R, Luchsinger JA. Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol. 2006 Dec;63(12):1709-17. Epub 2006 Oct 9.

Small GW, Kepe V, Ercoli LM, Siddarth P, Bookheimer SY, Miller KJ, et al. PET of brain amyloid and tau in mild cognitive impairment. N Engl J Med. 2006 Dec 21;355(25):2652-63.

Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008 Sep 11;337:a1344. doi: 10.1136/bmj.a1344.

Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006 Dec 20;296(23):2805-14.

Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and risk of Alzheimer disease. Arch Gen Psychiatry. 2007 Feb;64(2):234-40.

Reviewed last on: 6/24/2009
Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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