Optimizing Diagnosis and Management in mild-to-moderate Alzheimer’s Disease

Galvin, James E.

doi:10.2217/nmt.12.21

Cited by 8 publications

(8 citation statements)

References 97 publications

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“…In addition, some drugs must be used in combination to achieve the best therapeutic effect, which is also accompanied by increasing the risk of various adverse reactions [ 157 ]. Since 2003, the FDA has not approved a new drug for the treatment of AD [ 158 ]. Therefore, early diagnosis and treatment are essential.…”

Section: Future Directionsmentioning

confidence: 99%

Abnormal Homocysteine Metabolism: An Insight of Alzheimer’s Disease from DNA Methylation

Liu

Shi

2020

Behavioural Neurology

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Alzheimer’s disease (AD) is a chronic neurodegenerative disease in the central nervous system that has complex pathogenesis in the elderly. The current review focuses on the epigenetic mechanisms of AD, according to the latest findings. One of the best-characterized chromatin modifications in epigenetic mechanisms is DNA methylation. Highly replicable data shows that AD occurrence is often accompanied by methylation level changes of the AD-related gene. Homocysteine (Hcy) is not only an intermediate product of one-carbon metabolism but also an important independent risk factor of AD; it can affect the cognitive function of the brain by changing the one-carbon metabolism and interfering with the DNA methylation process, resulting in cerebrovascular disease. In general, Hcy may be an environmental factor that affects AD via the DNA methylation pathway with a series of changes in AD-related substance. This review will concentrate on the relation between DNA methylation and Hcy and try to figure out their rule in the pathophysiology of AD.

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Section: Future Directionsmentioning

confidence: 99%

Abnormal Homocysteine Metabolism: An Insight of Alzheimer’s Disease from DNA Methylation

Liu

Shi

2020

Behavioural Neurology

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“…Noncarriers of the apolipoprotein ε 4 allele have shown significant improvements in cognitive function with caprylidene. 75 Currently, there is limited published evidence to support using folic acid, vitamin B12, and N -acetylcysteine, 76 except in the setting of hyperhomocysteinemia. However, in older adults receiving folic acid supplementation for 3 years, plasma homocysteine levels were reduced and memory function improved compared with placebo.…”

Section: Pharmacotherapymentioning

confidence: 99%

A practical algorithm for managing Alzheimer's disease: what, when, and why?

Cummings

Isaacson

Schmitt

et al. 2015

Ann Clin Transl Neurol

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Alzheimer's disease (AD) is the most common form of dementia and its prevalence is increasing. Recent developments in AD management provide improved ways of supporting patients and their caregivers throughout the disease continuum. Managing cardiovascular risk factors, maintaining an active lifestyle (with regular physical, mental and social activity) and following a Mediterranean diet appear to reduce AD risk and may slow cognitive decline. Pharmacologic therapy for AD should be initiated upon diagnosis. All of the currently available cholinesterase inhibitors (ChEIs; donepezil, galantamine, and rivastigmine) are indicated for mild-to-moderate AD. Donepezil (10 and 23 mg/day) and rivastigmine transdermal patch (13.3 mg/24 h) are indicated for moderate-to-severe AD. Memantine, an N-methyl-d-aspartate receptor antagonist, is approved for moderate-to-severe AD. ChEIs have been shown to improve cognitive function, global clinical status and patients' ability to perform activities of daily living. There is also evidence for reduction in emergence of behavioral symptoms with ChEI therapy. Treatment choice (e.g., oral vs. transdermal) should be based on patient or caregiver preference, ease of use, tolerability, and cost. Treatment should be individualized; patients can be switched from one ChEI to another if the initial agent is poorly tolerated or ineffective. Memantine may be introduced in moderate-to-severe disease stages. Clinicians will regularly monitor symptoms and behaviors, manage comorbidities, assess function, educate and help caregivers access information and support, evaluate patients' fitness to drive or own firearms, and provide advice about the need for legal and financial planning. Review of caregiver well-being and prompt referral for support is vital.

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“…The objective in this case would be to detect the disease earlier than current usual care and to begin interventions and treatments when they might be most effective. Additional benefits would provide patients and providers to address modification of risk factors through change in diet, exercise and life-style [5,6].…”

Section: Introductionmentioning

confidence: 99%

Using Informant and Performance Screening Methods to Detect Mild Cognitive Impairment and Dementia

Galvin

2018

Curr Geri Rep

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An optimal approach to dementia screening is to combine performance, informant, and self-reports, many of which can be completed in the waiting room or by non-physician staff prior to the start of the office visit. This diverse information may help inform the provider as to the presence or absence of a cognitive disorder, assist in staging the extent of the disorder, and help to develop a differential diagnosis and management plan.

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Optimizing Diagnosis and Management in mild-to-moderate Alzheimer’s Disease

Cited by 8 publications

References 97 publications

Abnormal Homocysteine Metabolism: An Insight of Alzheimer’s Disease from DNA Methylation

Abnormal Homocysteine Metabolism: An Insight of Alzheimer’s Disease from DNA Methylation

A practical algorithm for managing Alzheimer's disease: what, when, and why?

Using Informant and Performance Screening Methods to Detect Mild Cognitive Impairment and Dementia

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