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Alzheimer Disease

John P Barrett, MD, MPH, MS Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Alzheimer disease (AD) is a progressive, irreversible, degenerative neurologic disease that results in neuron death.

  • AD represents 60-80% of dementia.

  • AD is the sixth leading cause of ...

DIAGNOSIS

  • “Welcome to Medicare” preventive visit and Medicare Annual Wellness Visit both require assessment of cognitive function.

  • Diagnosis of dementia requires exclusion of delirium. Delineating spec...

TREATMENT

GENERAL MEASURES

  • Optimize treatment of risk factors and associated comorbid conditions (e.g., hearing).

  • Advanced care planning before individual loses ability for independent decisions

  • Assess c...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Medication reconciliation each visit, including OTCs

  • Recommend: healthy lifestyle: exercise, nutrition, sleep, being socially and cognitive activ...

REFERENCES

1
Alzheimer's Association. 2021 Alzheimer's disease facts and figures. Alzheimers Dement. 2021 Mar;17(3):327-406.
2
Atri A. The Alzheimer’s disease clinical spectrum: diagnosis and management....

ADDITIONAL READING

The Gerontological Society of America. The GSA KAER toolkit for primary care teams. Washington, DC: The Gerontological Society of America; 2020. https://www.ger...

SEE ALSO

Delirium; Depression; Hypothyroidism, Adult; Substance Use Disorders 

CODES

ICD10

  • G30 Alzheimer's disease

  • G30.1 Alzheimer's disease with late onset

  • G30.9 Alzheimer's disease, unspecified

  • G31.84 Mild cognitive impairment, so stated

  • G30.0 Alzheimer's disease with early onset

  • G3...

CLINICAL PEARLS

  • AD is very common, >32% in those >85 years, and greatly underdiagnosed.

  • Imaging not needed for diagnosis for typical AD.

  • Early diagnosis allows advance care planning (e.g., advance...

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