Early diagnosis and treatment of Alzheimer’s disease

Abstract

Recently, focus on early detection, diagnosis and treatment of Alzheimer’s disease (AD) has been increasing. The rationale is that, as with any other serious illness, early intervention will lead to better outcomes for patients and families. Despite the intuitive appeal of this rationale, there is discussion and even debate regarding the issues surrounding early detection and treatment. This review begins with a futuristic case that is aimed at focusing this discussion/debate and then proceeds to consider each of the issues including: should AD screening be part of routine physical examinations? is the amyloid hypothesis correct?: implications for diagnosis and treatment? can neuroimaging studies be used to detect brain amyloid? can symptomatic medications be combined to facilitate cognition? can cognitive rehabilitation programs facilitate cognition? and can immunotherapy and other plaque-busting therapies modify the progression of AD?

Keywords::

• Alzheimer’s disease
• amyloid neuroimaging
• cognitive
• disease-modifying treatment
• early diagnosis
• early treatment
• rehabilitation
• screening
• symptomatic treatment

Financial & competing interests disclosure

Paul R Solomon and Cynthia A Murphy have received research grant support from Abbott, Astellas, Astra Zeneca, Avid, Bristol Myers Squibb, Eisai, Elan, EPIX, Forrest, GlaxoSmithKline, Lilly, Janssen, Novartis, Neurochem, Pfizer, Merck, Myriad, Sanofi, Takeda, Voyager and Wyeth. Paul R Solomon has received consulting fees from Abbott, Avid, Eisai, EPIX, Fujisawa, Takeda and Toyoma, and has served on the speakers bureau for Eisai, Forrest, Pfizer and Janssen. Cynthia A Murphy has received consulting fees from Mitsubishi Pharmaceuticals.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was used in the production of this manuscript.