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Alzheimer Disease

John P. Barrett, MD, MPH, MS, FAAFP, FACPM Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Alzheimer disease (AD) is the most common cause of dementia: 60–80% of those afflicted with dementia.

  • AD is a progressive, irreversible, degenerative neurologic disease that results i...

DIAGNOSIS

Diagnosis of dementia is straightforward. Diagnosis of the specific dementia–type cause may not be straightforward and requires a thorough history, examination, cognitive testing, and potent...

TREATMENT

GENERAL MEASURES

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

  • Assess environment for safety/security; avoid sudden changes to environm...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Review all health conditions and medications, including OTCs, vitamins, and supplements.

  • Recommend:

    • Healthy lifestyle: exercise, nutrition, sleep,...

REFERENCES

1
Alzheimer’s Association. 2018 Alzheimer’s disease facts and figures. Alzheimers Dement.  2018;14(3):367–429. [View Abstract on OvidMedline]
2
Livingston G, Sommerlad A, Orgeta V, et al....

ADDITIONAL READING

The Gerontological Society of America. KAER tool kit: 4-step process to detecting cognitive impairment and earlier diagnosis of dementia. https://www.geron.org/images/gsa/kaer/kaert...

CODES

ICD10

  • G30.9 Alzheimer’s disease, unspecified

  • G30.0 Alzheimer’s disease with early onset

  • G30.1 Alzheimer’s disease with late onset

  • F02.81 Dementia in oth diseases classd elswhr w behavioral disturb

  • G3...

CLINICAL PEARLS

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

  • Imaging not needed for diagnosis for typical of AD

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

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