The Alzheimer's Disease Clinical Spectrum: Diagnosis and Management

Atri, A.

Medical Clinics of North America 103(2): 263-293

2019


ISSN/ISBN: 1557-9859
PMID: 30704681
DOI: 10.1016/j.mcna.2018.10.009
Accession: 066446763

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Abstract
Alzheimer's disease (AD) care requires timely diagnosis and multidisciplinary management. Evaluation involves structured patient and caregiver history and symptom-function reviews, examination, and testing (laboratory and neuroimaging) to delineate impairment level, determine the cognitive-behavioral syndrome, and diagnose cause. Clinical biomarkers are available to aid high confidence in etiologic diagnosis. Management uses psychoeducation, shared goal setting, and patient-caregiver dyad decision making. When combined, pharmacologic and nonpharmacologic therapies mitigate symptoms and reduce clinical progression and care burden. AD biopathologic processes develop over decades before symptoms manifest; this period is increasingly targeted in research as an opportunity to best delay or prevent AD dementia.