To date, only symptomatic therapies for Alzheimer disease (AD) are available. All drugs approved by the US Food and Drug Administration (FDA) for the treatment of AD modulate neurotransmitters, either acetylcholine or glutamate. The standard medical treatment for AD includes cholinesterase inhibitors (ChEIs) and a partial N -methyl-D-aspartate (NMDA) antagonist.[65] [66]

Secondary symptoms of AD (eg, depression, agitation, aggression, hallucinations, delusions, sleep disorders) can be problematic. Behavioral symptoms in particular are common and can exacerbate cognitive and functional impairment. The following classes of psychotropic medications have been used to treat these secondary symptoms[67] :

• Antidepressants
• Anxiolytics
• Antiparkinsonian agents
• Beta-blockers
• Antiepileptic drugs (for their effects on behavior)
• Neuroleptics

Most studies of psychotropic drugs for AD have demonstrated no or limited efficacy. However, many issues make interpretation of data from these studies difficult.… [Continue Reading]

Alzheimer disease (AD) is an acquired disorder of cognitive and behavioral impairment that markedly interferes with social and occupational functioning. It is an incurable disease with a long and progressive course. AD not only has detrimental effects on the patient but often takes a significant toll on patients’ families and caretakers as well.

The most common form of dementia, AD affects about 5.4 million people in the United States alone, and that number is projected to reach 12-16 million by the year 2050[1] (see Epidemiology). Economically, AD is a major public health problem. In the United States in 2011, the cost of health care, long-term care, and hospice services for people aged 65 years and older with AD and other dementias was expected to be $183 billion, and this figure does not include the contributions of unpaid caregivers.[1]

Currently, an autopsy or brain biopsy is the only way to make a definitive diagnosis of AD. In clinical practice, the diagnosis is usually made on the basis of the history and findings on Mental Status Examination (see Presentation).

Symptomatic therapies are the only treatments available for AD. The standard medical treatments include cholinesterase inhibitors and a partial N -methyl-D-aspartate (NMDA) antagonist. Psychotropic medications are often used to treat secondary symptoms of AD, such as depression, agitation, and sleep disorders.… [Continue Reading]

Supplement to MAYO CLINIC HEALTH LETTER OCTOBER 2008

Alzheimer’s diseas. New research brings hope.

You’ve misplaced your car keys — again. Family members keep mentioning conversations you don’t remember having. You’ve been finding it difficult to concentrate, and you’re more irritable than you used to be. You won­der if these changes are a normal part of aging or something more serious — Alzheimer’s disease.

Healthy microtubules the loss of intellectual and social abilities severe enough to interfere with within a neuron daily functioning. (See “Dementia and Alzheimer’s,” page 2.) The Alzheimer’s Association estimates that 5.2 million older Americans have Alzheimer’s. This number is expected to increase dramatically over the next few Tau molecules decades — potentially reaching 11 million to 16 million by 2050. Although there’s no cure for Alzheimer’s disease, researchers have made progress. Treatments are available that improve the quality of life for some people with Alzheimer’s, and more drugs are being studied. If you do have Alzheimer’s or another form of dementia, the sooner you’re evaluated and diagnosed.… [Continue Reading]