Introduction

O Alzheimer S disease (AD) is a nonreversible, progressive dementia manifested by gradual deterioration in cognition and behavioral disturbances. AD is primarily diagnosed by exclusion of other potential causes for dementias. There is no single symptom unique to AD; therefore, diagnosis relies on a thorough patient history. The exact pathophysiologic mechanism underlying AD is not entirely known, although certain genetic and environmental factors may be associated with the disease. There is currently no cure for AD; however, drug treatment can slow symptom progression over time.

Family members of AD patients are profoundly affected by the increased dependence of their loved ones as the disease progresses. Referral to an advocacy organization, such as the Alzheimer's Association, can provide early education and social support of both the patient and family, which is also important treatment. The Alzheimer's Association has developed a checklist of common symptoms (Table 35-1).1

Table 35-1 Ten Warning Signs of AD

1. Memory loss: more than typical forgetfulness without remembering later

2. Difficulty performing familiar everyday tasks (e.g., preparing a meal and grooming)

3. Problems with language: forgetting simple words or substituting unusual words

4. Disorientation to time and place: may forget where they are and/or how they got there

5. Poor or decreased judgment: dress without regard to weather or falling prey to scam artists

6. Problems with abstract thinking: not just difficulty balancing a checkbook, but forgetting what the numbers represent

7. Misplacing things in unusual places: such as placing an iron in a freezer

8. Changes in mood or behavior: rapid mood swings with no apparent reason

9. Changes in personality: extreme confusion, suspicion, or fearfulness 10. Loss of initiative: passivity and loss of interest in usual activities

From Ref 1.

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