[Alzheimer type dementia: is early diagnosis significant?]

Presse Med. 2000 Apr;29(15):871-5.
[Article in French]

Abstract

ADVANTAGES OF EARLY DIAGNOSIS: Better prognosis and quality of life for patients with Alzheimer's disease and their caregivers depends on early diagnosis as specific treatment (anticholinesterase drugs) early in the disease process can have a beneficial effect on cognition and psychiatric or behavioral disorders. In addition early diagnosis gives the physician the opportunity to provide adapted advice for the patient and caregivers especially important in preventing complications and helping the family cope with the inevitable disruption of the family pattern caused by the disease, a situation which is particularly for the "designated caregiver".

Predementia states: The question of early diagnosis raises several types of problems. Defining the limits of the disease is particularly difficult: when does Alzheimer type dementia start? what is the definition of predementia? A growing body of work suggests that it is warranted to identify patients at risk of developing Alzheimer type dementia since, according to certain authors, they can benefit from specific treatment.

Risk factors: The only fully recognized risk factors are age, family history of dementia and presence of the allele epsilon 4 of the apolipoprotein E gene. There are probably several other risk factors. Their identification is a current subject of debate.

Tools for early diagnosis: Psychometric tests have been shown to provide specific information useful for interpreting the clinical assessment which must focus on detecting early signs and exploring even minimal memory deficiencies.

MeSH terms

  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / genetics
  • Cholinesterase Inhibitors / therapeutic use
  • Donepezil
  • Humans
  • Indans / therapeutic use
  • Mental Status Schedule
  • Neuropsychological Tests
  • Nootropic Agents / therapeutic use
  • Piperidines / therapeutic use
  • Prognosis
  • Psychometrics
  • Risk Factors
  • Time Factors

Substances

  • Cholinesterase Inhibitors
  • Indans
  • Nootropic Agents
  • Piperidines
  • Donepezil