Alzheimer disease

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By David S Geldmacher MD

Alzheimer disease is the prototypical and, by far, most common dementia. In this clinical summary, Dr. David S Geldmacher, Director of the Division of Memory Disorders and Behavioral Neurology at the University of Alabama at Birmingham, presents an overview of the disease, including clinical manifestations, pathophysiology, etiology, and diagnostic workup. Also included is information on results from clinical trials of exercise and treatments for neuropsychiatric symptoms.

Key points

  • Alzheimer disease is the most common cause of dementia.
  • Memory loss is the dominant feature in most patients, often accompanied by anomia, visuospatial deficits, and executive dysfunctions.
  • Current anti-dementia drugs most often reduce decline rather than improve cognition.
  • Apathy, depression, and agitation are frequent noncognitive symptoms.
  • The usefulness of antipsychotic drugs for treatment of agitation is modest and limited by increased mortality risks; citalopram may be a better choice for many patients.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited