Recognition and treatment of Alzheimer's disease: a case-based review.
Early recognition and treatment initiation are pivotal in managing Alzheimer's disease (AD). Once a diagnosis of AD is made, a treatment plan is developed and should include treatment initiation with cholinesterase inhibitors (ChEIs) to improve cognition, management of comorbid conditions, and treat behavioral symptoms. Caregiver compliance is integral to AD treatment success. The purpose of this report is to present two real case studies of "suspected" AD or related dementia and stress the significance of early and accurate diagnosis in disease management. In case 1, a caregiver reports gradual but progressive loss of memory, and the patient himself complains of memory impairment. Neuroimaging analysis confirms "typical " AD. In case 2, initiation of ChEI therapy is followed by substantial clinical improvement in the face of a complex medical picture, and neuroimaging revealing more neurodegenerative changes than could be accounted for by "pure" AD.
Marseille
Dana M
DM
Neuronuclear Imaging Section, Division of Biological Imaging, David Geffen School of Medicine, University of California at Los Angeles Medical Center, Los Angeles, California, USA.
Silverman
Daniel H S
DH
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy*; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002230:Carbidopa / Q000627:therapeutic use; D017028:Caregivers; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003937:Diagnosis, Differential; D000077265:Donepezil; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D007980:Levodopa / Q000627:therapeutic use; D020961:Lewy Body Disease / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D009483:Neuropsychological Tests; D010880:Piperidines / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D014810:Vitamin E / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
D000978:Antiparkinson Agents; D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D014815:Vitamins; D014810:Vitamin E; D007980:Levodopa; D000077265:Donepezil; D002230:Carbidopa