The Pharmaceutical Journal
Vol 277 No 7428 p643-646
25 November 2006

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Understanding Alzheimer’s disease

It has been 100 years since the features of Alzheimer’s disease were first described. Since then our understanding of it has increased but there is still no cure. In this article, Alan Worsley and Andrew Husband outline how the disease is currently managed

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SUMMARY

Alzheimer’s disease (AD) is a chronic neurodegenerative disorder and the fourth leading cause of death in developed countries after heart disease, cancer and stroke. This disease is the leading cause of dementia in the elderly — incidence in 60–64 year olds is approximately 1 per cent but this increases to 40 per cent in those aged 85 and over.

The symptoms of AD were first identified by the German psychiatrist Emil Kraepelin in individuals between the ages of 45 and 65 years. These include progressive memory loss and cognitive functional decline. In the later stages of the disease, patients become unable to perform activities of daily living (eg, brushing teeth, tying shoe laces, etc). Such inactivity results in reduced musculature and is likely to lead to residential care.

Most patients also experience behavioural (eg, sleeplessness, aggression and apathy) and psychiatric (eg, delusions and hallucinations) problems.

Various risk factors have been suggested for AD (see Panel 1). Although not all have good supporting evidence, pharmacists could advise on risk reduction measures, such as giving up smoking.

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