Alzheimer's disease: update in prevention, diagnosis and treatment
Keywords:
Dementia, Alzheimer's disease, cognitive impairment, prevention, biomarkers.Abstract
Introduction: Worldwide, nearly 55 million people are living with dementia. It is estimated that this number will reach nearly 82 million in 2030 and over 152 million in 2050, unless the risk factors are identified and interventions are implemented to prevent, delay the onset, and slow or stop its progression.
Objective: To provide an update on recent changes in the epidemiology, diagnosis and treatment of Alzheimer's disease.
Material and Methods: Bibliographic review of the literature on this subject published between January 1, 2012 and December 30, 2021 in PubMed/MEDLINE, EMBASE Lilacs, SciELO and Cochrane CENTRAL databases, using the terms " Alzheimer”, OR “dementia”, OR “cognitive impairment”.
Results: The governments must prepare for a tsunami of demands for health services as a result of the world population aging and improve the diagnoses, including biomarkers and emerging pharmacological treatments. The timely detection of cognitive impairment, and the causal diagnosis and proper management of the nosological entity is crucial.
Conclusions: The health systems should introduce annual neurocognitive assessments on a global level for people over 55 years of age, facilitated by the development of biomarker science, with the opportunity to promote risk reduction strategies. The existence of potentially modifiable risk factors means that dementia can be prevented through the implementation of a public health strategy with key interventions that delay or slow down the onset of cognitive impairment and dementia.Downloads
References
1. Gauthier S, Rosa Neto P, Morais JA, Webster C. World Alzheimer Report 2021: Journey through the diagnosis of dementia [Internet]. London: Alzheimer’s Disease International; 2021 [Citado 01/01/2022]. Disponible en: https://www.alzint.org/resource/world-alzheimer-report-2021/
2. Tsao C, Aday A, Almarzooq Z, Alonso A, Beaton A. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulación. 2022; 145:153-639.
3. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ 2009; 339:332-6.
4. Scheltens P, De Strooper B, Kivipelto M, Holstege H, Chételat G, Teunissen CE, t al. Alzheimer’s disease. Lancet. 2021; 397:1577-90.
5. Organización Mundial de la Salud. Plan de acción mundial sobre la respuesta de salud pública a la demencia 2017-2025 [Internet]. Ginebra: Organización Mundial de la Salud; 2017 [Citado 01/01/2022] Disponible en: https://www.who.int/mental_health/neurology/dementia/action_plan_2017_2025/en/
6. GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health, 2022; S2468-2667(21):00249-8.
7. JLlibre Rodríguez JJ, Valhuerdi A, López AM, Noriega. Cuba´s Aging and Alzheimer Longitudinal Study. MEDICC Review. 2017;19(1).
8. Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020; 396:413-26.
9. Loy CT, Schofield PR, Turner AM. Genetics of dementia. Lancet 2014; 383(9919):828-40.
10. Liu CC, Kanekiyo T, Xu H, Bu G. Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy. Nat. Rev. Neurol.2013; 9:106-118.
11. McDade E, Libre Guerra JJ, Holtzman DM, Morris JC, Randall JB. The informed road map to prevention of Alzheimer Disease- a call to arms. Molecular Neurodegeneration. 2021;16(49): 2-19.
12. Petersen RC, Lopez O, Armstrong MJ. Practice guideline update summary: mild cognitive impairment: report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology. 2018; 90(3):126-35.
13. McKhann G, Drachmann D, Folstein M. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984; 34:939-44.
14. Dubois B, Villain N, Frisoni GB, Rabinovici GD, Sabbagh M, Cappa S, et al. Clinical diagnosis of Alzheimer’s disease: recommendations of the International Working Group. Lancet Neurol. 2021; 20:484-96.
15. Atri A. The Alzheimer´s Disease Clinical Spectrum. Diagnosis and Management. Med Clin N Am 2019; 103: 263-93.
16. National Institute for Health and Care Excellence. Dementia: assessment, management and support for people living with dementia and their carers (NG97) [Internet]. EE UU: National Institute for Health and Care Excellence; 2018 [Citado 01/01/2022] Disponible en: https://pubmed.ncbi.nlm.nih.gov/30011160/
17. Gauthier S, Patterson C, Chertkow H. Recommendations of the 4th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD4). Can Geriatr J. 2012;15(4):120-6.
18. Howard R, McShane R, Lindesay J. Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer’s Disease (DOMINO-AD) trial: secondary and post-hoc analyses. Lancet Neurol. 2015; 14(12):1171-81.
19. Patel L, Grossberg G. Combination therapy for Alzheimer’s disease. Drugs & aging. 2011;28: 539-46.
20. Salloway S, Farlow M, McDade E, Clifford DB, Wang G, Llibre Guerra JJ, et al. A trial of gantenerumab or solanezumab in dominantly inherited Alzheimer’s Disease. Nat Med. 2021; 27:1187-96.
21. Cummings J, Aisen P, Lemere C, Atri A, Sabbagh M, Salloway S. Aducanumab produced a clinically meaningful benefit in association with amyloid lowering. Alzheimers Res Ther. 2021;13(1):10-98.
22. Aprueban Registro Sanitario Condicional de NeuroEPO para el tratamiento del Alzheimer leve y moderado. Granma [Internet]. 2022 Mar 8 [Citado 01/01/2022]; Secc. Salud. Disponible en.: https://www.granma.cu/cuba-covid-19/2022-03-08/aprueban-registro-sanitario-condicional-de-neuroepo-para-el-tratamiento-del-alzheimer-leve-y-moderado-08-03-20
23. Kivipelto M, Mangialasche F, Snyder HM, Allegri R, Andrieu S, et al. World-Wide FINGERS Network: a global approach to risk reduction and prevention of dementia. Alzheimer's and Dementia. 2020;16(7):1078-94.
Download PDF
