Alzheimer’s disease is a progressive and fatal neurodegenerative disorder manifested by cognitive and memory deterioration, progressive impairment of activities of daily living, and a variety of neuropsychiatric symptoms and behavioral disturbances. Prevalence studies suggest that in 2000 the number of persons with Alzheimer’s disease in the United States was 4.5 million. The percentage of persons with Alzheimer’s disease increases by a factor of two with approximately every five years of age, meaning that 1 percent of 60-year-olds and about 30 percent of 85-year-olds have the disease. Without advances in therapy, the number of symptomatic cases in the United States is predicted to rise to 13.2 million by 2050. The cost of caring for patients with Alzheimer’s disease is extraordinary; annual expenditures total $83.9 billion (in 1996 U.S. dollars). These figures underscore the urgency of seeking more effective therapeutic interventions for patients with Alzheimer’s disease.
Treatment of Alzheimer’s disease includes five major components: neuroprotective strategies, cholinesterase inhibitors, nonpharmacologic interventions and psychopharmacologic agents to reduce behavioral disturbances, health maintenance activities, and an alliance between clinicians and family members and other caregivers responsible for the patient. Treatment requires accurate diagnosis and increasingly is based on an understanding of the pathophysiology of the disease.
Alzheimer Disease, NEJM
Alzheimer’s Disease, 2004, NEJM