The Alzheimer's Disease Clinical Spectrum: Diagnosis and Management

Alireza Atri

doi:10.1016/j.mcna.2018.10.009

The Alzheimer's Disease Clinical Spectrum: Diagnosis and Management

Med Clin North Am. 2019 Mar;103(2):263-293. doi: 10.1016/j.mcna.2018.10.009.

Author

Alireza Atri¹

Affiliation

¹ Banner Sun Health Research Institute, Banner Health, 10515 W Santa Fe Drive, Sun City, AZ 85351, USA; Department of Neurology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: alireza.atri@bannerhealth.com.

PMID: 30704681
DOI: 10.1016/j.mcna.2018.10.009

Abstract

Alzheimer's disease (AD) care requires timely diagnosis and multidisciplinary management. Evaluation involves structured patient and caregiver history and symptom-function reviews, examination, and testing (laboratory and neuroimaging) to delineate impairment level, determine the cognitive-behavioral syndrome, and diagnose cause. Clinical biomarkers are available to aid high confidence in etiologic diagnosis. Management uses psychoeducation, shared goal setting, and patient-caregiver dyad decision making. When combined, pharmacologic and nonpharmacologic therapies mitigate symptoms and reduce clinical progression and care burden. AD biopathologic processes develop over decades before symptoms manifest; this period is increasingly targeted in research as an opportunity to best delay or prevent AD dementia.

Keywords: Alzheimer’s disease; Cognitive; Donepezil; Memantine; Mild cognitive impairment; Neuroimaging; Review; Treatment.

Publication types

Review

MeSH terms

Alzheimer Disease / diagnosis*
Alzheimer Disease / therapy*
Biomarkers
Diagnosis, Differential
Disease Progression
Humans
Neuroimaging
Parkinson Disease / diagnosis

Substances

Biomarkers