Alzheimer's disease

Carly Oboudiyat, Hilary Glazer, Alon Seifan, Christine Greer, Richard S. Isaacson

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Alzheimer's disease (AD) is the most common neurodegenerative cause of dementia and is responsible for significant individual morbidity and mortality, and economic impact on the health care system. Neurodegeneration (including neuronal atrophy and/or loss) are attributed to extraneuronal toxic amyloid oligomers and proteins, intraneuronal neurofibrillary tangles consisting of hyperphosphorylated tau, region-specific diminished cerebral glucose metabolism, synaptic dysfunction, and mitochondrial dysfunction. Several of these pathologic changes may occur decades before symptom onset, leaving ample time for implementing prevention strategies that target the earliest stages of the disease. In recent years, a myriad of modifiable and nonmodifiable risk factors have been elucidated. We describe the latest criteria for the diagnosis of AD, including earliest diagnostic stage of preclinical AD, which has the highest potential for research, including diagnosis and disease modification. We discuss both FDA-approved pharmacologic treatments, as well as nonpharmacologic strategies for AD therapeutics, including prevention via evidence-based, low-risk interventions. Genotype is an important consideration in managing patients on the AD continuum, as presence of the APOE ε4 allele may influence response to treatment. We present the most current evidence relating to pharmacogenomics, nutrigenomics, and distinctive nutritional requirements targeted toward AD.

Original languageEnglish (US)
Pages (from-to)313-329
Number of pages17
JournalSeminars in Neurology
Volume33
Issue number4
DOIs
StatePublished - Nov 22 2013

Keywords

  • Alzheimer's diet
  • Alzheimer's disease
  • Alzheimer's prevention
  • APOE ε4
  • beta amyloid
  • brain glucose hypometabolism
  • diet
  • ketogenic diet
  • ketone bodies
  • ketosis
  • major neurocognitive disorder
  • medical foods
  • mild cognitive impairment
  • mild neurocognitive disorder
  • NIA-AA criteria
  • nonpharmacologic therapy
  • nutrigenomics
  • pharmacogenomics
  • preclinical Alzheimer's disease
  • supplements
  • tau

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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  • Cite this

    Oboudiyat, C., Glazer, H., Seifan, A., Greer, C., & Isaacson, R. S. (2013). Alzheimer's disease. Seminars in Neurology, 33(4), 313-329. https://doi.org/10.1055/s-0033-1359319