Cognition and aging


Early detection of Alzheimer’s Disease

Nowadays, the early diagnosis of Alzheimer’s disease (AD) becomes a major challenge in psychogeriatric medicine, as disease-modifying pharmacological treatments for AD are currently under development. Patients might benefit from cognition-enhancing or disease-modifying drugs It is generally assumed that these treatments will have the greatest efficacy early in the course of dementia. Despite considerable progress with regard to the diagnostic work-up of dementia, the early diagnosis of AD remains an important challenge since it is still difficult to discriminate early dementia from depression on clinical and neuropsychological grounds. Similar cognitive and affective problems can occur in both mild AD and so-called “depressive pseudodementia” or “dementia syndrome of depression”.
Besides depression and AD, which are considered to be among the most prevalent and disabling mental disorders among elderly, nowadays a lot of attention is paid to the concept of Mild Cognitive Impairment (MCI). MCI is defined as a boundary area between normal aging and dementia. However, although MCI is regarded as a precursor to dementia, not all people diagnosed with MCI will develop dementia. Some will go on to develop dementia or AD in particular (and are in fact prodromal AD patients), while others remain stable or even improve. In the light of an early diagnosis of AD, the importance of an early detection of preclinical/prodromal AD among MCI patients becomes obvious.
Taken all this together, it appears that, in the early detection of AD, not only the differentiation between AD and elderly depression is important, but it also becomes an important challenge to psychogeriatricians to recognize AD in its preclinical/prodromal stage among so called MCI-patients.

 

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