Alzheimer’s disease (AD) is an age-dependent neurodegenerative disorder and the most common cause of dementia with aging. The early stages of AD are characterized by short-term memory loss. Once the disease progresses, patients experience difficulties in sense of direction, oral communication, calculation, ability to learn, and cognitive thinking. In addition, patients may develop language deficits, depression, aggressive behavior, and psychosis during the late stages, and eventually they need total care from caregivers. Currently diagnosis of AD is based either on clinical presentation or on biological biomarkers, in particular radiological and cerebrospinal fluid Amyloid, tau and phospho-tau levels. Here, the main clinical aspects and diagnostic tools for AD are revised; atypical AD presentations and possible diagnostic pitfalls are also discussed.
Alzheimer’s disease Biomarkers Neurodegeneration
This is a preview of subscription content, log in to check access.
McKhann G, Drachman DA, Folstein M, Katzman R, Price D, Stadlan EM. 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. 1984;34:939–44.PubMedCrossRefGoogle Scholar
Dubois B, Feldman HH, Jacova C, Dekosky ST, Barberger-Gateau P, Cummings J, et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol. 2007;6:734–46.PubMedCrossRefGoogle Scholar
Hort J, O’Brien JT, Gainotti G, Pirttili T, Popescu BO, Rektorova I, et al. EFNS guidelines for the diagnosis and management of Alzheimer’s disease. Eur J Neurol. 2010;17(10):1236–48.PubMedCrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (IV-TR). 4th ed, text revised. Washington, DC: American Psychiatric Association; 2000.Google Scholar
Bartus RT, Dean III RL, Beer B, Lippa AS. The cholinergic hypothesis of geriatric memory dysfunction. Science. 1982;217:408–14.PubMedCrossRefGoogle Scholar
Knowles J. Donepezil in Alzheimer’s disease: an evidence-based review of its impact on clinical and economic outcomes. Core Evid. 2006;1(3):195–219.PubMedCentralPubMedGoogle Scholar
Courtney C, Farrell D, Gray R, Hills R, Lynch L, Sellwood E, et al. AD2000 Collaborative Group. Long-term donepezil treatment in 565 patients with Alzheimer’s disease (AD2000): randomised double-blind trial. Lancet. 2004;363:2105–15.PubMedCrossRefGoogle Scholar
Birks J, Evans JG, Iakovidou V, Tsolaki M. Rivastigmine for Alzheimer’s disease. Cochrane Database Syst Rev. 2009;2, CD001191.PubMedGoogle Scholar
Qaseem A, Snow V, Cross Jr TJ, Forciea MA, Hopkins Jr R, Shekelle P, et al. 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. 2008;148:370–8.PubMedCrossRefGoogle Scholar
Mendez MF, Ghajarania M, Perryman KM. Posterior cortical atrophy: clinical characteristics and differences compared to Alzheimer’s disease. Dement Geriatr Cogn Disord. 2002;14:33–40.PubMedCrossRefGoogle Scholar
Tang-Wai DF, Graff-Radford NR, Boeve BF, Dickson DW, Parisi JE, Crook R, et al. Clinical, genetic, and neuropathologic characteristics of posterior cortical atrophy. Neurology. 2004;63:1168–74.PubMedCrossRefGoogle Scholar
Gorno-Tempini ML, Hillis AE, Weintraub S, Kertesz A, Mendez M, Cappa SF, et al. Classification of primary progressive aphasia and its variants. Neurology. 2011;76(11):1006–14.PubMedCentralPubMedCrossRefGoogle Scholar