Review Article of International Journal of Aging Research
Alzheimer’s Disease & Dementia-From Pathophysiology To Clinic
Paulo Roberto de Brito Marques*
*Professor Doctor, Director of the Discipline of Neurology, Faculdade de Ciências Médicas (FCM), University of Pernambuco (UPE). Preceptor of the Neurology Residency at the Universitary Hospital Oswaldo Cruz of FCM-UPE. Coordinator of the Center for Studies in Neurology of the Behavior of the Neurology Discipline at FCM-UPE. Member of the Alzheimer \Parkinson Committee for Technical-Scientific Advice and Honorary Provision – of the Pharmaceutical Assistance Management of the Pernambuco State Health Department.
Dementia is a syndrome that occurs due to the difficulty of a patient in doing his cognitive and instrumental activities of daily life with the same performance as before, bringing him losses. This syndrome is caused by numerous primary and secondary etiologies. The most common primary cause of dementia is Alzheimer’s disease (AD), which reaches almost 50% of dementia cases. The DA it consists of biological fragments of the amyloid precursor protein that are deposited in the brain 10 years or more, before the first symptoms appear. The period before the onset of symptoms is called the preclinical stage. The transition between the silence of symptoms and their appearance, usually due to memory loss for recent events, is known as the prodromal phase. Continuing the pathophysiological process, the stage of mild dementia takes place, when the patient has one more cognitive component associated with memory loss; follows the moderate, severe, profound and terminal phase of dementia.
Keywords: Alzheimer’s Disease,Dementia, Pathophysiology, Clinic
How to cite this article:
Paulo Roberto de Brito Marques. Alzheimer’s Disease & Dementia-From Pathophysiology To Clinic. International Journal of Aging Research, 2020, 3:70. DOI: 10.28933/ijoar-2020-08-1005
1. BRITO-MARQUES, PR The Art of Living with Alzheimer’s disease: from pathophysiology to diagnosis, Recife: EDUP E, 2006, p. 310.
2. BRITO-MARQUES, PR Alzheimer’s disease: Its Natural History. In: Leonardo Caixeta (Org.). De-mentia: a multidisciplinary approach. Rio de Janeiro: Atheneu, 2006, v.1, p.223-233.
3. . BRITO-MARQUES, PR Alzheimer’s disease: di-agnosis and treatment. In: Carlos Umberto Perei-ra and Antônio de Souza Andrade Filho (Org.) Neurogeriatria. Rio de Janeiro: Revinter, 2001, p.281-302.
4. BRITO-MARQUES, PR Cognitive Disorders and Dementia: differential diagnosis & treatment. Recife: EDUPE, 2018, p.498.
5. ALZHEIMER’S DISEASE INTERNATIONAL. World Alzheimer’s report, 2009.
6. NATIONAL INSTITUTE ON AGING: Why popula-tion aging matters: a global perspective 0 I had. NIH PUBL. Nº 07-6134. Bethesda, National on Aging, 2007.
7. CORIA, F; CASO, JA G; MINGUEZ, L; RO Driguez-Artalejo, F; CLAVERIA, LE Prevalence of age-associated memory impairmen t and de-mentia in a rural community. J Neurol, Neuro-surg, Psychiatr, 1993; 56: 973-976.
8. RIMMER, E; WOJCIECHOWSKA, M; STAVE, C; SGABGA, A; O’CONNELL, B. Implications of the Facing Dementia Survey for the general popula-tion, patients and caregivers across Europe. Int J Clin Pract Suppl., 2005 Mar; (146): 17-24.
9. ZIEGLER-GRAHAM, K; BROOKMEYER, R; JOHNSON, E; ARRIGHI, HM World variation in the doubling time of Alzheimer’s disease inci-dence rates. Alzheimer’s Dement 2008; 4: 316-323.
10. CORRADA, M. M; BROOKMEYER, R; PAGANI-NI-HILL, A; BERLAU, D; KAWAS, CH Dementia incidence continues to increase with age in the oldest old: the 90+ Study. Ann neurol, 2010; 67: 114-121.
11. SCHU, M. C; SHERVA, R; FARRER, LA The ge-netics of Alzheimer’s disease. In: Hampell H, Carrillo MC (eds): Alzheimer’s disease – Modern-izing concept, biological diagnosis and therapy. Adv Biol Psychiatry. Basel, Karger, 2012, vol 28, pp.15-29.
12. ROBERTS, G. W; GENTLEMAN, S. M; LYNCH, A; MURRAY, L; LANDON, M; GRAHAM, DI β Amyloid protein deposition in the brain after se-vere head injury: implications for the pathogene-sis of Alzheimer’s disease. J Neurol Neurosurg Psychiatry 1994; 57: 419-425.
13. GEERLINGS, M; den HEIJER, T; KOUDSTAAL, PJ; HOFMAN, A; BRETELER, MM History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology 2008 Apr 8; 70 (15): 1258-64.
14. McK HANN , G . M; K NOPMAN , D . S; C HERTKOW, H; H YMAN, B. T, J ACK , Jr; K AWAS C . H; et. al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging Alzheimer’s disease workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer dement 2011; 7 (3): 263-9.
15. D UBOIS, B; F ELDMEN, H. H; J ACOVA, C; et. al. Revising the definition of Alzheimer’s dis-ease: a new lexicon. Lancet Neurol 2010; 9: 1118–27.
16. DUBOIS, B; FELDMAN, H. H; JACOVA, C; et al. Research criteria for the diagnosis of Alzheimer’s disease: revising the NINCDS-ADRDA criteria. Lancet Neurol 2007; 6: 734-746.
17. KNOPMAN, DS; HAEBERLEIN, SB; CARRILLO, MC; HENDRIX, JA; KERCHNER, G; MARGOLIN, R; et. al. The National Institute on Aging and the Alzheimer’s Association. Research framework for Alzheimer’s disease perspectives from the re-search Roundtable. Alzheimer dement 2018; 14 (4): 563-575.
18. BRITO-MARQUES, PR Medicine in the face of a disease without a soul. Re v Bras Neurol Psiq, 1999; (3): 5-12.
19. MESULAM, MM Principles of Behavioral and Cognitive Neurology. Second edtion, Ox ford: Oxford University Press, 2000, p. 540.
20. BRITO-MARQUES PR & CABRAL-FILHO, JE. The Role of Education in Mini-Mental State Ex-amination: A study in Northeast Brazil. Arq Neu-ropsiquiatr. v.62 (2-A), p.206-211,2004.
21. BRITO-MARQUES, PR & CABRAL-FILHO, JE. The hole of education in Minimental State Exam-ination: a study in Northeast Brazil. Arq Neuro – psychiatrist. (Suppl 2), 2003.
22. FOLSTEIN MF; FOLSTEIN SE; McHUGH PR. “Mini-mental state”: a practical method for grad-ing the cognitive state of patients for the clini-cian. J Psychiat Res 1975; 12: 189-98.
23. BERTOLUCCI PHF, BRUCKI SMD, CAMPACCI SR, et al. The mini-examination of mental status in a general population: Impact of schooling. Arq Neuro-Psiquiatr 1994; 52: 1-7.
24. BRITO-MARQUES, PR. Modification of the Mini-Mental State Examination in accordance with the amount of schooling. Arq Neuropsiquiatr. 57 (Suppl 1), 1999
25. BRITO-MARQUES, PR. Modification of the Mini Mental State Examination due to Education. Re-cife: UFPE, Thesis (Neurology), 1999, 109p. Master in Neuro-psychiatry.
26. BRITO-MARQUES, PR & CABRAL-FILHO, JE. Relationship between the adapted Mini-Mental State Examination and the modified Mini-Mental State Examination in adult individuals with or without cognitive complaints. Arq Neurop-siquiatr. 63 (Suppl 1), 2005.
27. BRITO-MARQUES, PR & CABRAL-FILHO, JE. In-fluence of age and schooling on the perfor-mance in a modified mini-mental state examina-tion version: a study in Brazil Northeast. Arq Neuropsiquiatr. v.63, p.583-587,2005
28. Y ESAVAGE, JA, B Rink T. LR OSE, T. L et al. Development and validation of a geriatric de-pression screening scale: a preliminary report. J Psychiat Res 1983; 17: 37-49.
29. P ARADELA, EMP; L OURENÇO, RA; V ERAS, RP Validation of the geriatric depression scale in a general clinic. Validation of geriatric depres-sion scale in a general outpatient clinic. Rev. Saúde Pública 2005; 39 (6): 918-23
30. PFEIFFER, E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc, 1975; 23 (10): 433–441.
31. S CHELTENS, S. Early diagnosis of dementia: neuroimaging. J Neurol, 1999; 246: 16–20.
32. SKILLBACK, T; FARAHMAND, B. Y; ROSEN, C; ET. AL. Cerebrospinal fluid tau and amyloi d-beta1-42 in Patients with dementia. Brain 2015; 138: 2716-2731.
33. GALASKO, D; CLARK, C; CHANGE, L; ET. AL. Assessement of CSF levels of tau protein in mildly demented patients with Alzheimer’s dis-ease. Neurology 1997; 48: 632-635.
34. OININEM, H; S OLOMON, A; V ISSER, P. J; H ENDRIX, S. B ; B LENNOW, K; K IVIPELTO, M ; H ARTMANN, T ; LipiDiDiet clinical study group . 24-month intervention with a specific multinutrient in people with prodromal Alzheimer’s disease (LipiDiDiet): a randomized, double-blind, con-trolled trial. Lancet Neurol. 2017 Dec; 16 (12): 965-975.
35. WANG, L; HARMS, M. P; STAGGS, J. M; ET. AL. Donepezil Treatment Changes in Hippo and pitched in Structure Very Mild Alzheimer’s disea se. Arch Neurol 2010; 67: 99-106.
36. SPIEGEL, R. Rivastigmina: a review of its clini-cal effectiveness. Rev Neurol 2002; 35: 859-69
37. COREY-BLOOM, J. Galantamine: a review of its use in Alzheimer’s disease and vascular demen-tia. IJCP 2003; 57: 219-223
38. REISBERG, B; DOODY, R; STÖFFER, A; ET. AL. Memantine in Moderate-to-Severe Alzhei mer’s Disease. N Engl J Med 2003; 348: 1222-1341
39. ROPACKI, SA; JESTE, DV Epidemiology of and Risk Factors for Psychosis of Alzheimer’s Dis-ease: A Review of 55 Studies Published From 1990 to 2003. Am J Psychiatry 2005; 162: 2022–2030
40. American Psychiatric Association (APA). Diag-nostic and statistical manual of mental disorder: DSM-5. Arlington, VA: American Ps y chiatri c Publishing, 2013.