Alzheimer's disease: Seeing the signs early.
OBJECTIVE
Many patients with early symptoms of Alzheimer's disease (AD) first seek help from their primary care providers (PCPs). PCPs must therefore be watchful for signs and symptoms of AD, and should screen elderly patients who complain of memory and cognitive problems for dementia.


METHODS
Published literature on case detection, diagnosis, and treatment of AD.


CONCLUSIONS
There are a number of simple, accurate, and fast tools to facilitate case detection, including the Mini-Mental State Examination. Once a diagnosis has been made, healthcare providers, patients, and caregivers can evaluate treatment options. Several medications are available for symptomatic treatment of AD, including the cholinesterase inhibitors donepezil, galantamine, and rivastigmine, and for later stage disease, the N-methyl D-aspartate (NMDA) receptor antagonist, memantine.


CONCLUSIONS
Early intervention is critical because a delay in treatment is associated with nonreversible symptom progression. Realistic treatment expectations include reduction in symptom severity and slowed decline in cognition, function, and behavior. Treatment may allow patients to retain independence longer and reduce the burden that advanced AD places on caregivers.
Leifer
Bennett P
BP
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, New York, USA. leiferbp@optonline.net
D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D018450:Disease Progression; D005702:Galantamine / Q000627:therapeutic use; D006801:Humans; D008559:Memantine / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use; D018697:Nootropic Agents / Q000627:therapeutic use; D048448:Phenylcarbamates / Q000627:therapeutic use; D011320:Primary Health Care; D011594:Psychometrics; D000068836:Rivastigmine; D013997:Time Factors
D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D018697:Nootropic Agents; D048448:Phenylcarbamates; D005702:Galantamine; D000068836:Rivastigmine; D008559:Memantine