Alzheimer's disease--causes, risks, and diagnostic techniques
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Alzheimer's disease is the most significant cause of dementia in the elderly population. The rapid cognitive decline characteristic of this illness, coupled with the lack of a cure and a projected doubling of incidence within the next half century, has placed an impetus on research that focuses on developing early diagnostic tools. Earlier detection during the course of the disease may allow opportunities for the development of preventative and/or pharmaceutical measures that can possibly attenuate the progression or even prevent disease pathology for occurring. This paper outlines the current knowledge on the causes and diagnosis of AD in order to ascertain the most effective protocol for identifying pre-symptomatic individuals with the disease. One such method is to first select those at the highest risk of developing AD, and then performing periodic neuroimaging and cognitive assessments to ascertain the earliest manifestation. High-risk individuals include those with a family history of AD and/or other neurodegenerative disorders, in addition to those who already exhibit genetic markers for the disease, such as the Apolipoprotein Eε4 allele and the mutated protein Tau. Subjects who present with increased levels of cardiovascular risk factors for stroke, particularly hypertension and diabetes, are also at high risk for developing vascular dementia, which is another significant cause of AD. Disease incidence increases exponentially with advancing age. Consequently, individuals past the age of 65 who possess any combination of the above risk factors fall within the highest risk group. Advances in neuroimaging techniques and technology, like Magnetic Resonance Imaging and Positron Emission Tomography (PET), have allowed researchers to pinpoint the earliest pathological characteristics of AD, which includes cortical degeneration, amyloid plaques and neurofibrillary tangles. However, notwithstanding the recent discovery of the Pittsburg Compound B tracer used in PET, AD diagnosis via neuroimaging remains possible only when the pathological features are already present. Neuropsychological assessments, such as the Mini-Mental State Examination, are frequently used to assess the cognitive decline of patients with AD. Recent enhancements within the scoring of these tests, which has allowed for the incorporation of qualitative data, has given fruitful results and hopeful directions for diagnosing AD before pathogenesis occurs. However, due to the failure of clinical trials in discovering a cure, continued research into the realms of diagnosis and prevention of AD is of paramount importance in order to combat the impending epidemic.
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