Ultimately, AD could become a manageable chronic illness. Our hope that the combination of early disease diagnosis and intervention with novel disease-modifying therapeutics will allow individuals to age free from the scourge of dementia, able to retain their valuable memories and self-identity. Contributor Information Diana W. Shineman, The Alzheimer’s Drug Discovery Foundation, New York, Inhibitors,research,lifescience,medical NY, USA. Howard M Fillit, The Alzheimer’s
Drug Discovery Foundation, New York, NY, USA.
Alzheimer’s Disease (AD) is the epidemic of this century. All research efforts should be combined to find a cure for this devastating disease. Even postponing the onset of the disease by 5 years will halve its prevalence. Delay of institutional care will greatly diminish costs for society. One of the key elements in finding a new cure is being able to diagnose AD in its earliest form, ideally before symptoms occur. For this, Inhibitors,research,lifescience,medical neuroimaging already plays an important role, and this role will only increase in the coming years. Clinical findings Typically, AD is characterized by an insidious onset of cognitive decline, starting with deficits in episodic memory. Patients and their families complain, for example, of forgetting recent personal and family events, Inhibitors,research,lifescience,medical losing items around the house,
and repetitive questioning. As the disease progresses, other deficits, such as aphasia, apraxia, agnosia, visuospatial difficulties, and executive dysfunction, arise gradually. A simple test that relies on visuospatial and executive abilities Inhibitors,research,lifescience,medical is the clock-drawing test, of which a few examples
are given in Figure 1, an image of AD, avant la lettre. Figure 1. Inhibitors,research,lifescience,medical Alternative image of AD: clock drawings by patients with AD. In the clock-drawing test, the patient is asked to draw a clock and set the time for 10 past 11. Psychological and behavioral problems such as mood disorders, psychosis, agitation, and sleep disorders occur more frequently as the disease progresses. from The patient becomes increasingly dependent on others. Clinical diagnosis is made using criteria, of which the McKhann Bicalutamide cost criteria published in 19841 are the most widely validated and used. The criteria discern three categories of certainty: definite AD (established by postmortem or biopsy), probable AD (Table I) , and possible AD (when there are other explanations for the cognitive syndrome that are as likely). The average survival in AD is typically about 8 to 13 years from the onset of symptoms. Table I. National Institute of Neurological and Communicative Disorders and Stroke – Alzheimer’s Disease and Related Disorders Association (now Alzheimer’s Association) – NINCDS-ADRDA – criteria for probable Alzheimer’s disease.