Alzheimer's disease: stages, diagnosis and new treatments
Beyond memory loss
Dr. Antoine Mercier
Neurologist
A progressive neurodegenerative disease
Alzheimer's is the leading cause of dementia. Amyloid plaques and tau tangles accumulate in the brain, destroying neurons. Risk factors: age, ApoE4 genotype, cardiovascular comorbidities, hearing loss, low education.
Early signs
Recent memory loss, word-finding difficulties, disorientation in familiar places, behavioral changes, withdrawal from activities.
Modern diagnosis
Cognitive testing (MMSE, MoCA), brain MRI, CSF biomarkers (Aβ42, tau), amyloid PET. Blood biomarkers (p-tau217) now emerging.
Treatments
- Cholinesterase inhibitors (donepezil, rivastigmine) and memantine: symptomatic
- Lecanemab, donanemab: anti-amyloid antibodies, first disease-modifying drugs approved in early stages
- Non-drug: cognitive stimulation, physical activity, social engagement
Prevention
Control blood pressure, diabetes, manage hearing loss, Mediterranean diet, sleep, lifelong learning.
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