RT Journal Article
SR Electronic
T1 Alzheimer Disease: Standard of Diagnosis, Treatment, Care, and Prevention
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 981
OP 985
DO 10.2967/jnumed.121.262239
VO 63
IS 7
A1 Teipel, Stefan
A1 Gustafson, Deborah
A1 Ossenkoppele, Rik
A1 Hansson, Oskar
A1 Babiloni, Claudio
A1 Wagner, Michael
A1 Riedel-Heller, Steffi G.
A1 Kilimann, Ingo
A1 Tang, Yi
YR 2022
UL http://jnm.snmjournals.org/content/63/7/981.abstract
AB Alzheimer disease (AD) is the most frequent cause of dementia in people 60 y old or older. This white paper summarizes the current standards of AD diagnosis, treatment, care, and prevention. Cerebrospinal fluid and 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. Nonpharmacologic interventions and a healthy lifestyle (diet, socioaffective inclusion, cognitive stimulation, physical exercise, and others) provide some beneficial effects. Prevention targets mainly 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 these modifiable risk factors.