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      Alzheimer’s Disease – Why We Need Early Diagnosis

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          Abstract

          Alzheimer's disease is the leading cause of dementia. However, neither Alzheimer’s disease nor Alzheimer’s dementia are an inevitable consequence of aging. This review provides an overview of the issues involved in a diagnosis of Alzheimer’s disease before an individual meets the criteria for Alzheimer’s dementia. It examines how Alzheimer’s disease diagnosis rates can be improved, the implications of an early diagnosis for the individual, carer and society, and the importance of risk reduction to prevent or delay progression. Although no disease-modifying agents capable of reversing the initial pathological changes are currently available, it may be possible to prevent or delay the development of dementia in a proportion of the population by modifying exposure to common risk factors. In other individuals, diagnosing the disease or risk of disease early is still valuable so that the individual and their carers have time to make choices and plan for the future, and to allow access to treatments that can help manage symptoms. Primary healthcare professionals play a pivotal role in recognising individuals at risk, recommending lifestyle changes in mid-adult life that can prevent or slow down the disease, and in timely diagnosis. Early intervention is the optimal strategy, because the patient’s level of function is preserved for longer.

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          Most cited references26

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          2018 Alzheimer's disease facts and figures

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            Rate of progression of mild cognitive impairment to dementia--meta-analysis of 41 robust inception cohort studies.

            To quantify the risk of developing dementia in those with mild cognitive impairment (MCI). Meta-analysis of inception cohort studies. Forty-one robust cohort studies were identified. To avoid heterogeneity clinical studies, population studies and clinical trials were analysed separately. Using Mayo defined MCI at baseline and adjusting for sample size, the cumulative proportion who progressed to dementia, to Alzheimer's disease (AD) and to vascular dementia (VaD) was 39.2%, 33.6% and 6.2%, respectively in specialist settings and 21.9%, 28.9% and 5.2%, respectively in population studies. The adjusted annual conversion rate (ACR) from Mayo defined MCI to dementia, AD and VaD was 9.6%, 8.1% and 1.9%, respectively in specialist clinical settings and 4.9%, 6.8% and 1.6% in community studies. Figures from non-Mayo defined MCI and clinical trials are also reported. The ACR is approximately 5-10% and most people with MCI will not progress to dementia even after 10 years of follow-up.
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              Alzheimer's disease

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                Author and article information

                Journal
                Degener Neurol Neuromuscul Dis
                Degener Neurol Neuromuscul Dis
                DNND
                Degenerative Neurological and Neuromuscular Disease
                Dove
                1179-9900
                24 December 2019
                2019
                : 9
                : 123-130
                Affiliations
                [1 ]Psi-Napse , Dorking, Surrey, UK
                [2 ]Department of Medical Affairs, MSD Ltd , Hoddesdon, UK
                Author notes
                Correspondence: Jill Rasmussen Psi-Napse , Dorking, SurreyRH5 4HH, UKTel +44 1306 883 272 Email jill.rasmussen@psi-napse.com
                Author information
                http://orcid.org/0000-0003-4365-0428
                http://orcid.org/0000-0002-2688-1497
                Article
                228939
                10.2147/DNND.S228939
                6935598
                31920420
                328897b6-234f-4252-9109-dc5199f57d3d
                © 2019 Rasmussen and Langerman.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 28 August 2019
                : 16 November 2019
                Page count
                Figures: 1, Tables: 1, References: 50, Pages: 8
                Categories
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                alzheimer’s disease,alzheimer’s dementia,early diagnosis

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