Abstract
Alzheimer’s disease (DTA) constitutes the most common cause of dementia. Its prevalence is about 2–4% at the age of 70 and between 30% and 50% in persons over the age of 85.
The prevalence doubles every 5 years, being even more prevalent in women, which probably reflects their greater longevity. With the increase of life expectancy, the impact of this disease will keep growing significantly unless prevention and/or treatment actions are developed.
Many efforts in diagnostic methodology as well as trials used to stop the progression in this preclinical stage of investigation have been made and still continue, although at present there are not worldwide agreed or approved treatments for it.
Nowadays, there are five drugs that were approved by the FDA for probable DTA treatment; only four of them are used regularly.
Differential diagnosis of Alzheimer’s disease constitutes one of the most complex challenges in medicine.
We could say that we can found five possible variables for the differential diagnosis.
-
1.
Clinical interpretation
-
2.
Neuroimaging
-
3.
Differential blood check for cognitive disorders
-
4.
Genetic biomarkers (or data in lifetime clinical record, LCR)
-
5.
Neurocognitive evaluation
These items must be studied by a qualified stuff at specialized centers, if possible, to arrive at the closest diagnosis to reality. Finally, biomarkers and genetics constitute substantial progress that will lead to a sensitive and specific diagnosis at the same time.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
American Academy of Neurology (2009) AAN guideline summary for clinicians: detection, diagnosis and management of dementia. http://www.aan.com/professionals/practice/pdfs/dementia_guideline.pdf. Accessed 15 April 2009
Small GW, Siddarth P, Burggren AC et al (2009) Influence of cognitive status, age, and APOE-4 genetic risk on brain FDDNP positron-emission tomography imaging in persons without dementia. Arch Gen Psychiatry 66(1):81–87
Reisberg B, Auer SR (1996) Behavioral pathology in Alzheimer’s disease. Psychogeriatrics 8:301–308
Wragg RE, Jeste DV (1989) Overview of depression and psychosis in Alzheimer’s disease. Am J Psychiatry 146:577–587
Salzman C (1997) Treatment of the elderly agitated patient. J Clin Psychiatry 48(5 suppl):19–22
Schatzberg A, Nemeroff C (1998) Textbook of psychopharmacology, 2nd edn. American Psychiatric, Washington, DC
American Psychiatric Association (2009) Practice guideline and resources for treatment of patients with Alzheimer´s disease and other dementias, 2nd edn. http://www.psychiatryonline.com/pracGuide/pracGuideTopic_3.aspx. Accessed 15 April 2009
APA Work Group on Alzheimer´s Disease and other Dementias, Rabins PN, Blacker D et al (2007) American Psychiatric Association practice guideline for the treatment of patients with Alzheimer´s disease and other dementias. Second edition. Am J Psychiatry 164(12 suppl):5–56
Moizeszowicz J (1998) Psicofarmacología psicodinámica IV: estrategias terapéuticas y psiconeurobiológicas, 4th edn. Paidós, Buenos Aires
Raskind MA, Sadowsky CH et al (1997) Effect of tacrine on language, praxis and noncognitive behavioral problems in Alzheimer’s disease. Arch Neurol 54:836–840
Howard RJ, Juszczak E, Ballard CG et al (2007) Donepezil for the treatment of agitation in Alzheimer´s disease. N Engl J Med 357(14):1382–1392
Tariot PN, Farlow MR, Grossberg GT et al (2004) Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA 291:317–324
Farlow M et al (2003) Memantine/donepezil dual therapy is superior to placebo/donepezil therapy for treatment of moderate to severe Alzheimer´s disease. Neurology 60(suppl 1):A412
Reisberg B, Doody R, Söffler A et al (2003) Memantine in moderate to severe Alzheimer’s disease. N Engl J Med 348:1333–1341
Tolbert SR, Fuller MA (1996) Seleginine in treatment of behavioral and cognitive symptoms of Alzheimer disease. Ann Pharmacother 30:1122–1129
Kawas C, Resnik S, Morrison A (1997) A prospective study of estrogen replacement therapy and the risk of developing Alzheimer disease: the Baltimore longitudinal study of aging. Neurology 48:1517–1521
Rüther E, Ritter R, Apecechea M, Freytag S, Gmeinbauer R, Windisch M (2000) Sustained improvements in patients with dementia of Alzheimer’s type (DAT) 6 months after termination of cerebrolysin therapy. J Neural Transm 107:815–829
Ruether E, Alvarez XA, Rainer M, Moessles H (2002) Sustained improvement of cognition and global function in patients with moderately severe Alzheimer’s disease: a double-blind, placebo-controlled study with the neurotrophic agent Cerebrolysin®. J Neural Transm Suppl 62:265–275
Panisset M et al (2002) Cerebrolysin in Alzheimer’s disease: a randomized, double-blind, placebo-controlled trial with a neurotropic agent. J Neural Transm 109:1089–1104
Xiao SF et al (2000) Efficacy of FPF 1070 (Cerebrolysin) in patients with Alzheimer’s disease: a multicentre, randomized, double-blind placebo-controlled trial. Clin Drug Invest 19:43–53
Alvarez XA et al (2006) A 24-week double blind, placebo-controlled study of three dosages of Cerebrolysin in patients with mild to moderate Alzheimer’s disease. Eur J Neurol 13:43–54
Barnes R, Veith R, Okimoto J et al (1992) Efficacy of antipsychotic medications in behaviorally disturbed dementia patients. Am J Psychiatry 139:1170–1174
Qaseem A, Snow V, Cross JT et al (2008) Current pharmacologic treatment of dementia: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 148(5):370–378
Stern RG, Duffelmeyer ME et al (1991) The use of benzodiazepines in the management of behavioral symptoms in dementia patients. Psychiatr Clin North Am 14:375–384
Tariot PN, Erb R et al (1994) Carbamazepine treatment of agitation in nursing home patients with dementia: a preliminary study. J Am Geriatr Soc 42:1160–1166
Gleason RP, Schneider LS (1990) Carbamazepine treatment of agitation in Alzheimer’s outpatients refractory to neuroleptics. J Clin Psychiatry 51:115–118
Lott AD, Mcelroy SL, Keys MA (1995) Valproate in the treatment of behavioral agitation in elderly patients with dementia. J Neuropsychiatry Clin Neurosci 7:314–319
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer
About this chapter
Cite this chapter
Brusco, L.I. (2010). Cognitive Decline and Treatment of Alzheimer’s Disease. In: Miyoshi, K., Morimura, Y., Maeda, K. (eds) Neuropsychiatric Disorders. Springer, Tokyo. https://doi.org/10.1007/978-4-431-53871-4_15
Download citation
DOI: https://doi.org/10.1007/978-4-431-53871-4_15
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-53870-7
Online ISBN: 978-4-431-53871-4
eBook Packages: MedicineMedicine (R0)