Abstract

DIAGNOSIS, MANAGEMENT AND TREATMENT OF ALZHEIMER’S DISEASE

Mr. Vishal Nanaware*, Mr. Atharva Pachange, Mr. Venkatesh Murkute, Prof. Lalita Khambait, Dr. Tushar Shelke

Abstract

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the leading cause of dementia in older adults. It impairs communication between neurons and ultimately causes neuronal death. Pathologically, it is characterised by extracellular senile plaques composed of β-amyloid (Aβ) deposits and intracellular neurofibrillary tangles composed of abnormally hyperphosphorylated tau protein. The prevalence of dementia rises sharply with age worldwide and places a heavy financial burden on society. AD arises from a complex interaction of genetic, environmental, and demographic factors. Late-onset AD is strongly influenced by advanced age and the APOE ε4 allele, whereas early-onset AD is associated with rare autosomal dominant mutations in the APP, PSEN1, and PSEN2 genes. Low educational attainment, physical inactivity, poor diet, smoking, cardiovascular comorbidities, and chronic sleep disturbance are additional risk factors. Clinically, AD presents with subtle short-term memory loss, followed by executive dysfunction, agnosia, apraxia, disorientation, language impairment (aphasia), and noncognitive symptoms. Diagnosis rests on clinical history, cognitive screening (MMSE, MoCA), physical examination, and structural neuroimaging (MRI/CT), and is further refined by the ATN biomarker framework, which includes FDG-PET, amyloid-PET, and cerebrospinal fluid (CSF) measurements. Current pharmacological treatment relies mainly on acetylcholinesterase inhibitors and NMDA receptor antagonists for symptomatic relief, while emerging research is examining disease-modifying immunotherapies that target the removal of Aβ plaques.

Keywords: Alzheimer’s disease; cholinesterase inhibitors; diagnosis; memantine; genetics and risk factors; biomarkers; pharmacological treatment.