This type of dementia usually starts slowly, first affecting the parts of the brain responsible for memory, thinking, and language. Over time, these symptoms worsen up to the point of patients failing to recognize closest relatives and experiencing problems in basic activities of daily living such as dressing or grooming. In addition to the distinctive memory problems, Alzheimer patients develop other symptoms such as changes in reasoning skills, aphasia, apraxia, deficits in visuospatial abilities, and changes in mood and personality.
The neuropathological hallmarks of Alzheimer’s disease are senile plaques and neurofibrillary tangles in the cerebral cortex, as well as neuronal and synaptic loss.
The criteria for the clinical diagnosis of probable Alzheimer’s disease include the following:
- Dementia established by clinical examination and documented by neuropsychological tests
- Deficits in two or more areas of cognition
- Progressive worsening of memory and other cognitive functions
- No disturbance of consciousness
- Onset between ages 40 and 90
- Absence of systemic disorders or other brain diseases that in and of themselves could account for the progressive deficits in memory and cognition
Prognostic factors in Alzheimer’s disease are:
- Visuospatial deficits
- Extrapyramidal signs
- Psychosis, depression
- Initial severity of dementia, functional disability
- Malnutrition, diabetes mellitus, lack of physical exercise, and cardiovascular disease
Finally, regarding treatment, there is currently no drug that can reverse the symptoms of this disease. However, there are medications called acetylcholinesterase inhibitors which delay the progression of Alzheimer’s disease, especially in early to moderate stages.
References: McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan E. M. (1984). Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34(7), 939-44. doi: 10.1212/WNL.34.7.939 See more at: http://www.neurology.org/content/34/7/939.full.pdf+html
