Alzheimers Disease

About Alzheimers Disease

Alzheimers disease is the most common cause of dementia, contributing to an estimated 60 to 70 percent of cases. Dementia overall affects approximately 55 million people worldwide according to WHO, a number projected to rise substantially by 2050. Dr Alois Alzheimer described the disease in 1906 after examining the brain of Auguste Deter. The disease is characterized by amyloid beta plaques and tau neurofibrillary tangles in the brain, leading to neuronal death and brain atrophy. The most common early symptom is difficulty remembering newly learned information. As the disease progresses, symptoms worsen to include disorientation, mood and behavior changes, deepening confusion about events and time, unfounded suspicions about family and caregivers, difficulty speaking, swallowing, and walking. Risk factors include age strongest, genetics APOE4 allele, family history, cardiovascular factors, low education, social isolation, traumatic brain injury, and hearing loss. Diagnosis involves cognitive testing MMSE, MoCA, brain imaging MRI showing hippocampal atrophy, PET amyloid or tau imaging, and cerebrospinal fluid analysis. Medications include cholinesterase inhibitors donepezil, rivastigmine, galantamine for mild to moderate disease, memantine for moderate to severe disease, and the controversial anti amyloid antibodies lecanemab Leqembi and donanemab which modestly slow cognitive decline but carry risk of amyloid related imaging abnormalities ARIA.