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Epidemiologic Reviews Advance Access published online on July 16, 2008
Epidemiologic Reviews, doi:10.1093/epirev/mxn008
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Epidemiologic Reviews © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Article

Dementia of the Alzheimer Type

Jessica J. Jalbert1, Lori A. Daiello1,2 and Kate L. Lapane1

1 Department of Community Health – Epidemiology, Warren Alpert School of Medicine at Brown University, Providence, RI
2 Alzheimer's Disease and Memory Disorders Center, Rhode Island Hospital, Providence, RI

Correspondence to Jessica J. Jalbert, Department of Community Health – Epidemiology, Warren Alpert School of Medicine at Brown University, 121 South Main, Box G, Providence, RI 02912 (e-mail: Jessica_Jalbert{at}brown.edu).

accepted for publication May 12, 2008.

Dementia of the Alzheimer type is a progressive, fatal neurodegenerative condition characterized by deterioration in cognition and memory, progressive impairment in the ability to carry out activities of daily living, and a number of neuropsychiatric symptoms. This narrative review summarizes the literature regarding descriptive epidemiology, clinical course, and characteristic neuropathological changes of dementia of the Alzheimer type. Although there are no definitive imaging or laboratory tests, except for brain biopsy, for diagnosis, brief screening instruments and neuropsychiatric test batteries used to assess the disease are discussed. Insufficient evidence exists for the use of biomarkers in clinical practice for diagnosis or disease management, but promising discoveries are summarized. Optimal treatment requires both nonpharmacological and pharmacological interventions, yet none have been shown to modify the disease's clinical course. This review describes the current available options and summarizes promising new avenues for treatment. Issues related to the care of persons with dementia of the Alzheimer type, including caregiver burden, long-term care, and the proliferation of dementia special care units, are discussed. Although advances have been made, more research is needed to address the gaps in our understanding of the disease.

Alzheimer disease • dementia • drug therapy • review

APOE, apolipoprotein E • DAT, dementia of the Alzheimer type • DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth edition text revision • MMSE, Mini-Mental State Examination • NINCDS/ADRDA, National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorders Association


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