RT Journal Article
SR Electronic
T1 Alzheimer’s disease – standard of diagnosis, treatment, care, and prevention
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.121.262239
DO 10.2967/jnumed.121.262239
A1 Stefan Teipel
A1 Deb Gustafson
A1 Rik Ossenkoppele
A1 Oskar Hansson
A1 Claudio Babiloni
A1 Michael Wagner
A1 Steffie Riedel-Heller
A1 Ingo Kilimann
A1 Yi Tang
YR 2022
UL http://jnm.snmjournals.org/content/early/2022/02/10/jnumed.121.262239.abstract
AB Alzheimer’s disease (AD) is the most frequent cause of dementia in people > 60 years. This white paper summarizes the current standards of AD diagnosis, treatment, care, and prevention. Cerebrospinal fluid (CSF) and positron emission tomography (PET) measures of cerebral amyloidosis and tauopathy allow the diagnosis of AD even before dementia (prodromal stage) and provide endpoints for treatments aimed at slowing the AD course. Licensed pharmacologic symptomatic drugs enhance cholinergic pathways and moderate excess of glutamatergic transmission to stabilize cognition. Disease-modifying experimental drugs moderate or remove brain amyloidosis, but so far with modest clinical effects. Nonpharmacological interventions and a healthy lifestyle (diet, socio-affective inclusion, cognitive stimulation, physical exercise, etc.) provide some beneficial effects. Prevention mainly targets modifiable dementia risk factors such as unhealthy lifestyle, cardiovascular-metabolic and sleep-wake cycle abnormalities, and mental disorders. A major challenge for the future is telemonitoring in the real world of those modifiable risk factors.