RT Journal Article
SR Electronic
T1 Managing Alzheimer Dementia Tomorrow
JF The Journal of the American Board of Family Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 423
OP 434
DO 10.3122/jabfm.16.5.423
VO 16
IS 5
A1 Thomas C. Rosenthal
A1 Natan Khotianov
YR 2003
UL http://www.jabfm.org/content/16/5/423.abstract
AB Background: Acetylcholinesterase inhibitors are the first drugs to alter the devastating effects of Alzheimer disease. The next generation of drugs will prevent the β-amyloid plaques and neurofibrillary tangles or block enzymes that lead to neuron destruction. Effective use of these medications will require early identification of patients at risk.Methods: Using the PubMed service of the National Library of Medicine, all English language articles published in 2000, 2001 and the first half of 2002 with a key word of ‘dementia’ were reviewed for articles that described the emerging pathophysiologic model for Alzheimer disease.Findings: Standardized clinical screening tools, such as the mini-mental status examination and the clock test, administered longitudinally and correlated with family observations, can identify many at-risk patients. Genetic testing can identify a known mutation in 70% of patients who have a high family incidence of Alzheimer disease but awaits effective prevention before being useful. The molecular mechanisms of Alzheimer disease will eventually lead to prevention.Conclusion: Today, these patients benefit from nutritional support and lifestyle enhancement encouraged through a continuous primary care relationship.