June is Alzheimer disease awareness month. Alzheimer disease is the most common etiology of dementia. Over 5 million individuals in the United States have Alzheimer disease. Approximately 15% of individuals over age 65 have the disease, and 45% of those over age 85 are affected.
Signs and symptoms of Alzheimer disease often present insidiously, with mild memory impairment being the first notable symptom. The memory impairment progresses in severity and patients also develop word-finding difficulties as well as visuospatial deficits. Some patients may present atypically, with initial symptoms being word-finding difficulties or navigational problems, such as getting lost during a normal driving route.
Known risk factors for Alzheimer disease include advanced age, diabetes, and repeated head trauma with concussions. A small percentage, only about 2% cases, of Alzheimer disease is familial occurring through an autosomal dominant inheritance pattern. Many other risk factors have been postulated and are being explored to differing degrees. Potential risk factors include alcohol intake, hypercholesterolemia, hypertension, and even certain medications, such as proton-pump inhibitors. These potential risk factors need to be further studied to be affirmatively linked to the disease or disproven as having a causal relationship.
Currently, the FDA approved treatments for Alzheimer disease include donepezil, rivastigmine, galantamine, and memantine. These medications may help to slow cognitive decline, but do not prevent or reverse the effects of Alzheimer disease.
Visit the Alzheimer Disease Foundation to view the latest ongoing clinical trials related to the disease.
Read the following chapters to learn more about Alzheimer disease:
Clinical Neurology, 10e: Chapter 5: Dementia & Amnestic Disorders
Harrison's Principles of Internal Medicine, 19e: 448: Alzheimer’s Disease and Other Dementias