Alzheimer’s dementia

Table of Contents

• • Summary 3
  • Basics 4
    • Definition 4
    • Epidemiology 4
    • Aetiology 4
    • Pathophysiology 5
  • Prevention 6
    • Primary prevention 6
    • Screening 6
  • Diagnosis 7
    • Case history 7
    • Step-by-step diagnostic approach 7
    • Risk factors 9
    • History & examination factors 11
    • Diagnostic tests 12
    • Differential diagnosis 15
    • Diagnostic criteria 17
  • Treatment 20

• • Step-by-step treatment approach 20
  • Treatment details overview 25
  • Treatment options 26
  • Emerging 34
• Follow up 35
  • Recommendations 35
  • Complications 35
  • Prognosis 36
• Guidelines 37
  • Diagnostic guidelines 37
  • Treatment guidelines 37
• Online resources 41
• Evidence scores 42
• References 45
• Disclaimer 58

Summary

◊ Chronic, progressive neurodegenerative disorder characterised by a global, non-reversible impairment in cerebral functioning.

◊ Characterised by memory loss, loss of social and occupational functioning, diminished executive function, speech and motor deficits, personality change, plus behavioural and psychological disturbance.

◊ 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. Caregiver support groups are beneficial to caregivers and should be considered, where available.