Towards a science of Alzheimer's disease management: a model based upon current knowledge of retrogenesis.
BACKGROUND
General relationships between dotage and infancy and childhood have been acknowledged for more than two millennia. Recent findings indicate precise relationships between functional, praxic, and feeding changes in the course of the degenerative dementia of Alzheimer's disease (AD) and inverse corresponding developmental sequences. Similar inverse relationships between AD and human development can be described for cognition and language skills; for physiologic measures of electroencephalographic activity, brain glucose metabolism, and developmental neurologic reflex changes; and for the neuropathologic and neuroanatomic progression of these processes. In AD, these processes may be termed "retrogenesis." The relevance of the retrogenesis model for AD management is explored.


METHODS
The functional stages of AD can be translated into developmental age equivalents that can be utilized to explicate observed changes in the disease.


RESULTS
The retrogenesis-based developmental age model can usefully inform an understanding of the general care needs, emotional and behavioral changes, and activity needs of the AD patient. This model must be amended by necessary caveats regarding physical differences, variations in age-associated pathology, differences in social and societal reactions, and differences in background between AD patients and their developmental age "peers."


CONCLUSIONS
Knowledge of retrogenesis and the developmental age of the AD patient can form a nidus for the development of a nascent science of disease management. Such a science must ultimately incorporate not only appropriate caveats but also relevant universal human needs, such as those for dignity, love, and movement.
Reisberg
B
B
Zachary and Elizabeth M. Fisher Alzheimer's Disease Education and Resources Program, New York University Medical Center, New York 10016, USA. barry.reisberg@mcadr.med.nyu.edu
Kenowsky
S
S
Franssen
E H
EH
Auer
S R
SR
Souren
L E
LE
D000293:Adolescent; D000368:Aged; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000451:nursing* / Q000523:psychology*; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D016294:Models, Nursing; D008960:Models, Psychological; D005791:Patient Care / Q000379:methods*