Alzheimer Disease Questions & Answers

Updated: May 09, 2019
  • Author: Shaheen E Lakhan, MD, PhD, MS, MEd; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Questions & Answers

Overview

What is Alzheimer disease (AD)?

What physical and mental status test findings suggest Alzheimer disease (AD)?

What are signs of mild Alzheimer disease (AD)?

What are the signs and symptoms of moderate Alzheimer disease (AD)?

What are the symptoms of severe Alzheimer disease (AD)?

What are the signs of end-stage Alzheimer disease (AD)?

How is Alzheimer disease (AD) diagnosed?

What is the standard treatment for Alzheimer disease (AD)?

Which psychotropic medications are used to treat secondary symptoms of Alzheimer disease (AD)?

Can Alzheimer disease (AD) be prevented?

What is the prevalence of Alzheimer disease (AD)?

How is Alzheimer disease (AD) diagnosed?

What are the treatment options for Alzheimer disease (AD)?

How was Alzheimer disease (AD) first identified?

What is the role of genetics in the pathogenesis of Alzheimer disease (AD)?

What is the neuroanatomy of Alzheimer disease (AD)?

What is the role of neurofibrillary tangles (NFTs) and senile plaques (SPs) in the pathology of Alzheimer disease (AD)?

How does the pathophysiology of Alzheimer disease (AD) differ from that of normal aging?

How does destruction of nerve cells affect healthy neuron processes in patients with Alzheimer disease (AD)?

Which neuropathological event precedes the clinical onset of Alzheimer disease (AD)?

What is the composition of neurofibrillary tangles (NFTs) in Alzheimer disease (AD)?

What is the composition of senile plaques (SPs) in Alzheimer disease (AD)?

Which brain lesions are associated with Alzheimer disease (AD)?

What is the composition of plaques in Alzheimer disease (AD)?

How do plaques develop in Alzheimer disease (AD)?

How do tangles develop in Alzheimer disease (AD)?

Where do neurofibrillary tangles (NFTs) accumulate in the brain of a patient with Alzheimer disease (AD)?

Where do senile plaques (SPs) accumulate in the brain of a patient with Alzheimer disease (AD)?

When is the presence of neurofibrillary tangles (NFTs) and senile plaques (SPs) suggestive of Alzheimer disease (AD)?

Is low density neurofibrillary tangles (NFTs) suggestive of Alzheimer disease (AD)?

What is the relationship between amyloid deposition and neurofibrillary tangles (NFTs) in the pathogenesis of Alzheimer disease (AD)?

What is the role of beta-amyloid in the pathogenesis of Alzheimer disease (AD)?

Has the amyloid hypothesis for the pathogenesis of Alzheimer disease (AD) been proven?

Which factor may be predictive of Alzheimer disease (AD) severity?

What is the role of granulovacuolar degeneration in the pathogenesis of Alzheimer disease (AD)?

What is the role of the cholinergic system in the pathogenesis of Alzheimer disease (AD)?

What is the role of oxidative damage in the pathogenesis of Alzheimer disease (AD)?

What is the role of oxidative stress in in the pathogenesis of Alzheimer disease (AD)?

What is the role of reactive oxygen species (ROS) in the pathogenesis of Alzheimer disease (AD)?

What is the role of intracellular calcium in the pathogenesis of Alzheimer disease (AD)?

Does blocking the increase in free intracellular calcium decrease neuron injury in Alzheimer disease (AD)?

What is the role of the receptor for advanced glycation end products (RAGE) in the pathogenesis of Alzheimer disease (AD)?

How is receptor for advanced glycation end products (RAGE) expressed in patients with Alzheimer disease (AD)?

What is the role of inflammation and immune processes in the degenerative process in Alzheimer disease (AD)?

Do NSAIDs prevent senile plaque formation in patients with Alzheimer disease (AD)?

What is the role of unrelated class A scavenger receptors (class A SR) in the pathogenesis of Alzheimer disease (AD)?

What is the role of clusterin in the pathogenesis of Alzheimer disease (AD)?

What is the role of presenilin 1 (PS1) and presenilin 2 (PS2) in the neurogenetics of Alzheimer disease (AD)?

How are presenilin 1 (PS1) and presenilin 2 (PS2) detected in patients with Alzheimer disease (AD)?

What properties of presenilin 1 (PS1) may present future treatment options for Alzheimer disease (AD)?

What role does estrogen loss have in the pathogenesis of Alzheimer disease (AD)?

What is the etiology of Alzheimer disease (AD)?

What are the risk factors for Alzheimer disease (AD)?

What is a risk factor for developing Alzheimer disease (AD) in late-life?

What is the role of genetics in the etiology of Alzheimer disease (AD)?

Which genetic mutations cause early-onset autosomal dominant Alzheimer disease (AD)?

Which genes may be etiologic factors for late-onset Alzheimer disease (AD)?

Are patients with Down syndrome at increased risk for Alzheimer disease (AD)?

What is the role of skin fibroblasts in the pathogenesis of Alzheimer disease (AD)?

Does presenilin 1 (PS1) cause early-onset autosomal-dominant Alzheimer disease (AD)?

Do apolipoprotein E (APOE) E2 and E3 alleles increase the risk for Alzheimer disease (AD)?

What is the relationship between hypertension (high blood pressure), apolipoprotein E epsilon 4 (APOE E4) and Alzheimer disease (AD)?

What is the risk of developing Alzheimer disease (AD) in individuals with the apolipoprotein E epsilon 4 (APOE E4) allele?

Does exposure to fine particulate matter (PM) increase the risk for Alzheimer disease (AD)?

What is the role of insulin resistance in the pathogenesis of Alzheimer disease (AD)?

Which infectious agents may increase the risk for Alzheimer disease (AD)?

What is the role of depression in the etiology of Alzheimer disease (AD)?

What is the role of head trauma in the etiology of Alzheimer disease (AD)?

Do epigenetic factors have a role in the etiology of Alzheimer disease (AD)?

Does lead exposure have a role in the etiology of Alzheimer disease (AD)?

Is oxidative stress a possible cause of sporadic Alzheimer disease (AD)?

Do antioxidant supplements prevent Alzheimer disease (AD)?

Is vitamin E effective in the prevention of Alzheimer disease (AD)?

What is the prevalence of Alzheimer disease (AD) in the US?

How does the risk for Alzheimer disease (AD) vary between males and females?

What are the mortality rates of Alzheimer disease (AD) in the US?

What is the prevalence of Alzheimer disease (AD) in industrialized nations?

According to the WHO, how does the prevalence of Alzheimer disease increase after age 60?

What is the global prevalence of Alzheimer disease (AD)?

What is the age distribution for Alzheimer disease (AD)?

What is the relationship between dementia and Alzheimer disease (AD) in individuals older than 95 years?

Are males or females at greater risk for Alzheimer disease (AD)?

Does Alzheimer disease (AD) have a racial predilection?

What is the prognosis for Alzheimer disease (AD)?

What should be the emphasis when counseling patients and their families following a diagnosis of Alzheimer disease (AD)?

What should be discussed with patients as symptoms become more pronounced in Alzheimer disease (AD)?

What should be considered in day-to-day management decisions for patients with Alzheimer disease (AD)?

What resources may be helpful for patients and their families regarding Alzheimer disease (AD)?

Presentation

What is the presentation of Alzheimer disease (AD)?

Who should provide the history for a patient with suspected Alzheimer disease (AD) and what should be noted?

What should be considered when taking the history of a patient with suspected Alzheimer disease (AD)?

What should be included in the initial mental status testing for Alzheimer disease (AD)?

What are the cognitive symptoms of early Alzheimer disease (AD)?

What are standardized mental assessments for Alzheimer disease (AD)?

When is a complete neurologic exam performed in the diagnosis of Alzheimer disease (AD)?

What are the stages of Alzheimer disease (AD)?

What is mild cognitive impairment (MCI) in patients with Alzheimer disease (AD)?

What is the presentation of preclinical Alzheimer disease (AD)?

What are signs and symptoms of mild Alzheimer disease (AD)?

How does mild Alzheimer disease (AD) progress?

What is the expected reaction of patients and families to the initial diagnosis of Alzheimer disease (AD)?

What is the presentation of moderate Alzheimer disease (AD)?

What are the symptoms of moderate Alzheimer disease (AD)?

How does moderate Alzheimer disease (AD) affect behavior?

What may provide a sense of security to patients with Alzheimer disease (AD)?

How are judgement and impulse control affected by moderate Alzheimer disease (AD)?

What is the presentation of severe Alzheimer disease (AD)?

What are secondary symptoms of severe Alzheimer disease (AD)?

What are the signs of end-stage Alzheimer disease (AD)?

What is the official term for dementia in Alzheimer disease (AD) in the DSM-5?

Which organizations have released clinical guidelines for the diagnosis of Alzheimer disease (AD)?

What are the NIH-Alzheimer’s Disease and Related Disorders Association (NIH-ADRDA) criteria for the diagnosis of Alzheimer disease (AD)?

What are the 2011 National Institute on Aging/Alzheimer’s Association (NIA-AA) criteria for the diagnosis of Alzheimer disease (AD)?

What are the DSM-5 criteria for the diagnosis of Alzheimer disease (AD)?

DDX

How is depression diagnosed in patients with Alzheimer disease (AD)?

Which instruments are used for assessing depression in patients with Alzheimer disease (AD)?

How is chronic traumatic encephalopathy (CTE) differentiated from Alzheimer disease (AD)?

How does the distribution of neurofibrillary tangles (NFTs) in CTE differ from that in normal aging and Alzheimer disease (AD)?

What are the symptoms of chronic traumatic encephalopathy (CTE)?

Which disorders should be considered in the differential diagnoses of Alzheimer disease (AD)?

What are the differential diagnoses for Alzheimer Disease?

Workup

What is the role of imaging studies in the diagnosis of Alzheimer disease (AD)?

How are the National Institute on Aging/Alzheimer’s Association (NIA-AA) diagnostic criteria for Alzheimer disease (AD) used?

What are AAN recommendations for lab tests in the evaluation of Alzheimer disease (AD)?

Is vitamin D deficiency a reversible cause of Alzheimer disease (AD)?

What are the AAN recommendations for neuroimaging in the initial evaluation of patients with dementia?

Which biomarker has validity for Alzheimer disease (AD) neuropathology?

What is the role of MRI and default mode network (DMN) imaging in the evaluation of Alzheimer disease (AD)?

What is the efficacy of MRI in the diagnosis of Alzheimer disease (AD)?

What is the efficacy of MRI plus CSF biomarkers for the diagnosis of early Alzheimer disease (AD)?

What default mode network (DMN) imaging findings suggest Alzheimer disease (AD)?

What are the roles of SPECT scanning and PET scanning in the diagnosis of Alzheimer disease (AD)?

What are the Amyloid Imaging Taskforce (AIT) guidelines for the use of amyloid beta PET imaging in the diagnosis of Alzheimer disease (AD)?

What is the role of florbetapir F 18 in the diagnosis of Alzheimer disease (AD)?

What is the efficacy of florbetapir-PET imaging for the diagnosis of Alzheimer disease (AD)?

What is the role of flutemetamol F18 (Vizamyl) in the diagnosis of Alzheimer disease (AD)?

Is florbetaben F18 (Neuraceq) effective for the diagnosis of Alzheimer disease (AD)?

Which tests are effective in identifying Alzheimer disease (AD) before symptoms appear?

What is the role of EEG in the diagnosis of Alzheimer disease?

What is the role of lumbar puncture in the diagnosis of Alzheimer disease (AD)?

What is the role of cerebrospinal fluid (CSF) analysis in the diagnosis of Alzheimer disease (AD)?

What is the role of genetic testing in the diagnosis of Alzheimer disease (AD)?

What is the role of apolipoprotein E (APOE) genotyping in the evaluation of Alzheimer disease (AD)?

What are the concerns regarding genotyping for Alzheimer disease (AD) risk assessment in asymptomatic individuals?

What are the ACMG and the NSGC testing guidelines for genes associated with early onset Alzheimer disease (AD)?

Treatment

What are the treatment options for Alzheimer disease (AD)?

Which medications have been used to treat the secondary symptoms of Alzheimer disease (AD)?

What is the efficacy of psychotropic drugs for Alzheimer disease (AD)?

What pharmacologic research is being conducted for the treatment of Alzheimer disease (AD)?

When is hospitalization indicated in patients with Alzheimer disease (AD)?

What are the benefits of early diagnosis and treatment of Alzheimer disease (AD)?

What is impaired early in the course of Alzheimer disease (AD)?

Which agents have been approved by the FDA for the treatment of Alzheimer disease (AD)?

What is the efficacy of cholinesterase inhibitors (ChEIs) for the treatment of Alzheimer disease (AD)?

What are adverse effects of cholinesterase inhibitors (ChEIs) for the treatment of Alzheimer disease (AD)?

What are the possible adverse effects of abrupt termination of cholinesterase inhibitors (ChEIs) in patients with Alzheimer disease (AD)?

How should changing cholinesterase inhibitors (ChEIs) be handled in patients with Alzheimer disease (AD)?

Should patients with Alzheimer disease (AD) be treated with cholinesterase inhibitors (ChEIs) and anticholinergic agents simultaneously?

Which mental activities may reduce the risk of Alzheimer disease (AD)?

How should mental activities be selected in the treatment of mild Alzheimer disease (AD)?

Is cognitive rehabilitation effective in the treatment for Alzheimer disease (AD)?

How does memantine (Namenda, Namenda XR) work to treat moderate to severe Alzheimer disease (AD)?

Is memantine (Namenda, Namenda XR) effective for the treatment of Alzheimer disease (AD)?

Is rivastigmine transdermal effective in the treatment of severe Alzheimer disease (AD)?

Are psychotropic medications approved by the FDA for the treatment of Alzheimer disease (AD)?

Which behavioral interventions are used in the treatment of Alzheimer disease (AD)?

What are the FDA black-box warnings for the use of atypical neuroleptics in the treatment of secondary symptoms of Alzheimer disease (AD)?

What are the concerns regarding the use of neuroleptic agents for the treatment of secondary symptoms of Alzheimer disease (AD)?

What is the role of neuroleptic agents for the treatment of secondary symptoms of Alzheimer disease (AD)?

What is the role of antidepressants in the treatment of secondary symptoms of Alzheimer disease (AD)?

What is the role of citalopram in the treatment of secondary symptoms of Alzheimer disease (AD)?

Are SSRIs effective in the treatment of secondary symptoms of Alzheimer disease (AD)?

Is trazodone effective for the treatment of sleep disturbances in patients with Alzheimer disease (AD)?

Which agents are used for the treatment of disruptive behaviors in patients with advanced Alzheimer disease (AD)?

What is the role of anticonvulsants in the treatment of Alzheimer disease (AD)?

What other agents have demonstrated prolonged total sleep time at night in patients with Alzheimer disease (AD)?

What is the role of anti-inflammatory drugs in the treatment of Alzheimer disease (AD)?

Which experimental therapies have been proposed for Alzheimer disease (AD)?

Which antiamyloid therapy studies have been conducted for the treatment of Alzheimer disease (AD)?

Are there any therapeutic agents that reverse excess tau phosphorylation in patients with Alzheimer disease (AD)?

Is free-radical scavenger therapy effective therapy for Alzheimer disease (AD)?

What has been found to slow the progression of disease in patients with moderate Alzheimer disease (AD)?

What is the role of estrogen therapy in the treatment of Alzheimer disease (AD)?

What is the role of statins in the treatment of Alzheimer disease (AD)?

What is the role of transcranial magnetic stimulation (TMS) in the treatment of Alzheimer disease (AD)?

What is the theory behind disease-modifying therapies for delaying the onset of Alzheimer disease (AD)?

What is the role of neuropsychological, neuroimaging, and genetic testing in the treatment of Alzheimer disease (AD)?

What is the role of caprylidene (Axona) in the treatment of Alzheimer disease (AD)?

Which lifestyle changes may reverse cognitive decline in patients with Alzheimer disease (AD)?

What is the effect of cardiorespiratory fitness on Alzheimer disease (AD) progression and brain health?

Which activities should be encouraged in patients with Alzheimer disease (AD)?

Which factors may reduce the risk of Alzheimer disease (AD)?

Does cardiovascular fitness prevent Alzheimer disease (AD)?

Which dietary changes may be beneficial for Alzheimer disease (AD) prevention?

Does calorie reduction increase cognitive function?

Does alcohol consumption increase the risk of Alzheimer disease (AD)?

Medications

What is the mainstay of therapy for patients with Alzheimer disease (AD)?

Which medications in the drug class Cholinesterase Inhibitors are used in the treatment of Alzheimer Disease?

Which medications in the drug class N-Methyl-D-Aspartate Antagonists are used in the treatment of Alzheimer Disease?

Which medications in the drug class Nutritional Supplement are used in the treatment of Alzheimer Disease?

Which medications in the drug class Diagnostic Imaging Agents are used in the treatment of Alzheimer Disease?

Which medications in the drug class Combination Drugs are used in the treatment of Alzheimer Disease?