Alzheimer’s Disease The Challenge of the
阿尔兹海默症诊断新标准
阿尔兹海默症诊断新标准NEW CRITERIA AND GUIDELINES FOR THE DIAGNOSIS OF ALZHEIMER’S DISEASE PUBLISHED FOR FIRST TIME IN 27 YEARS - Research Agenda Suggested for Detecting Pre-Symptomatic Alzheimer’s –- New Alzheimer’s Definition Moves Researchers Closer to Early Detection and Intervention –CHICAGO, April 19, 2011 – For the first time in 27 years, new criteria and guidelines for the diagnosis of Alzheimer‟s disease have been published by three expert workgroups spearheaded by the Alzheimer‟s Association and the National Institute on Aging (NIA) of the National Institutes of Health (NIH).The workgroups published four articles including ready-to-use clinical diagnostic criteria for Alzheimer‟s disease dementia and mild cognitive impairment (MCI) due to Alzheimer‟s. A research agenda was proposed for preclinical Alzheimer‟s. The use of biomarkers in Alzheimer‟s dementia and MCI due to Alzheimer‟s was also proposed as a research agenda only, and is not intended for application in clinical settings at this time.The articles – collectively, the National Institute on Aging/Alzheimer‟s Association Diagnostic Guidelines for Alzheimer‟s Disease – expand the definition of Alzheimer‟s to include two new phases of the disease: (1) presymptomatic and (2) mildly symptomatic but pre-dementia, along with (3) dementia caused by Alzheimer‟s. This reflects current thinking that Alzheimer‟s begins creating distinct and measurable changes in the brains of affected people years, perhaps decades, before memory and thinking symptoms are noticeable.“It is our hope that incorporating scientific knowledge gained and technological advances made over the past quarter century will improve current diagnosis, bring the field closer to earlier detection and treatment, and ultimately lead to effective disease-modifying therapies,” said William Thies, Ph.D., Chief Medical and Scientific Officer at the Alzheimer‟s Association. “Development and publication of these articles is a major landmark in the field. That said, publication of these articles is not yet the end of the process of developing new diagnostic criteria for Alzheimer‟s, but is another major step in the process.”“The new guidelines reflect today‟s understanding of how key changes in the brain lead to Alzheimer‟s disease pathology and how they relate to the clinical signs of mild cognitive impairment and Alzheimer‟s disease dementia,” said Creight on Phelps, Ph.D., Program Director of the Alzheimer‟s Disease Centers Program at the National Institutes of Health. “We are also beginning to be able to detect these changes at a preclinical stage, long before symptoms appear in many people. With further research on biomarkers, as set forth in the new guidelines, we may ultimately be able to predict who is at risk for development of mild cognitive impairment and Alzheimer‟s dementia, and who would benefit most as interventions are developed.”The proposed new Alzheimer‟s disease diagnostic guidelines were published online today by Alzheimer‟s & Dementia: The Journal of the Alzheimer‟s Association. Hard copy publication is scheduled for the May 2011 issue of the journal.The current diagnostic criteria for Alzheimer‟s*, for the most part, focus on reliable diagnosis when signs of problems in thinking, learning, and memory are noticeable to an individual, family, and friends. But research tells us that Alzheimer‟s likely begins years, maybe even decades, prior to symptoms appearing.The new articles refer to three phases of Alzheimer‟s disease progression over time: Measurable changes in biomarkers (such as brain imaging and spinal fluid chemistry) that indicate the very earliest signs of disease, before outward symptoms are visible. Currently, there are no clinical diagnostic criteria for this phase, but the group provides a scientific framework to help researchers better define this stage of Alzheimer‟s. (See supplement 5.) Mild changes in memory and thinking abilities, enough to be noticed and measured, but not impairment that compromises everyday activities and functioning. Memory, thinking and behavioral symptoms that impair a person‟s ability to function in daily life. (For more details, see supplement 3.)According to the authors, in order to facilitate the possibility of future presymptomatic treatment of Alzheimer‟s, it was important to define the disease from the earliest changes in the brain, not only the observable, symptomatic stages of the disease. The authors propose that Alzheimer‟s begins with a long asymptomatic period during which detrimental changes are progressing in the brain, and individuals with biomarker evidence of these changes are at increased risk for developing cognitive and behavioral impairment and progression to Alzheimer‟s dementia.A biomarker is a naturally occurring, measurable substance or condition in the body that reliably indicates the presence or absence of disease or the risk of later developing a disease; for example, blood glucose levels are a biomarker of diabetes, and cholesterol levels are a biomarker of cardiovascular disease risk. Both fluid and imaging measures are being tested as possible biomarkers for Alzheimer‟s. (See supplement 4.)There was a broad consensus within the workgroups that much additional research needs to be done to validate the application of biomarkers as they are proposed in the newly-published articles. According to the authors, “The definitive studies … are lik ely to take more than a decade to fully accomplish. Thus, we must move quickly … and adjust our models and study designs as new data become available.”“If we can definitively determine the risk of developing Alzheimer‟s dementia in people who have biomarker evidence of brain changes but are not showing outward symptoms, we will open an important window of opportunity to intervene with disease-modifying therapies, once they are developed,” Thies said.“In addition, the new criteria give us powerful tools to accelerate our knowledge in the fight against Alzheimer‟s disease. They give us guidelines for getting a more accurate assessment ofAlzheimer‟s prevalence. In that way we can better assess the need for everything from research dollars to care services, to patient and caregiver education materials, to nursing home beds, to the number of gerontologists and nurses that we need. And, they give us a basis for creating the next generation of Alzheimer‟s treatments th at will be effective in each stage of the disease,” Thies said.The Alzheimer‟s Association, in its 2010 report titled “Changing the Trajectory of Alzheimer‟s Disease: A National Imperative,” showed that a hypothetical intervention that delayed the ons et of Alzheimer‟s dementia by five years would result in a nearly 45 percent reduction in the number of people with Alzheimer‟s by 2050, and reduce the projected Medicare costs of Alzheimer‟s from $627 billion to $344 billion dollars.The authors of the newly-released articles write, “It is our hope that the advances in preclinical detection of Alzheimer‟s will enable earlier, more effective treatment, just as nearly all of therapeutic gains in cancer, cardiovascular disease, osteoporosis, and diabetes involve treatment before significant clinical symptoms are present. Screening and treatment programs instituted for other diseases … have already been associated with a decrease in mortality due to these conditions.”Thies adds, “Currently, Alzheimer‟s therapies are in development that may be able to slow or stop the progression of the disease. By improving early detection and risk evaluation, we will better be able to test potential therapies and eventually prescribe them for people at increased risk. Ultimately, this approach envisions for Alzheimer‟s what is now common practice in cardiovascular disease, where early signs of risk – for example, in genetic markers or in blood cholesterol and/or blood pressure levels – can be treated to reduce the likelihood of heart attack or stroke later on.”The challenge for Alzheimer‟s now is that there is currently no single, generally accepted way to identify the disease in the earliest stage –before symptoms are evident. It is hoped that the research agenda outlined in the new preclinical Alzheimer‟s article will correct this deficit.According to the authors, “The concept of a preclinical phase of disease should not be too foreign. Medical professionals readily acknowledge that cancer can be detected at the stage of …carcinoma in situ‟and that hypercholesterolemia and atherosclerosis can result in narrowing of coronary arteries that is detectable prior to myocardial infarction. It is widely acknowledged that symptoms are not necessary to diagnose human disease. Type II diabetes, hypertension, renal insufficiency, and osteoporosis are frequently detected through laboratory tests, and effective treatment can prevent the emergence of symptoms.”“We should be open to the idea that Alzheimer‟s could one day be diagnosed preclinically by the presence of biomarker evidence, which may eventually guide therapy prior to the onset of symptoms. We treat people with diabetes, elevated cholesterol, hypertension and a variety of other illnesses – we do not wait for strokes, heart attacks or other long term complications that we knowwill occur in significant numbers of those affected. Similarly, our intention is to use these criteria to better determine an individual‟s risk of developing Alzheimer‟s disease. This diagnostic research will help us discover the drugs of the future and prepare for the day when we can administer them to those at risk in order to prevent or delay the emergence of symptoms,” wrote the authors.The proposed new diagnostic criteria and research agenda for Alzheimer‟s disease are presented in three documents, plus an introduction.One workgroup updated the 1984 diagnostic criteria for the dementia due to Alzheimer‟s disease. Guy McKhann, M.D., Johns Hopkins University School of Medicine, Baltimore, and David Knopman, M.D., Mayo Clinic, Rochester, Minn., co-chaired this panel.A second workgroup focused on refining the criteria for the symptomatic, pre-dementia phase, referred to as Mild Cognitive Impairment due to Alzheimer‟s disease. Marilyn Albert, Ph.D., Johns Hopkins University School of Medicine, Baltimore, chaired this workgroup.The third workgroup proposed a research agenda (NOT criteria for clinical diagnosis; this is an important distinction. See supplement 4.) for the asymptomatic, preclinical phase of Alzheimer‟s. Reisa Sperling, M.D, Brigham and Women's Hospital, Harvard Medical School, Boston, chaired this group.The introduction provides an overview of the changes that have occurred in the Alzheimer‟s field since the first diagnostic criteria were published in 1984, and outlines future challenges that need to be addressed. Clifford Jack, M.D., Mayo Clinic, Rochester, Minn., is lead author of this article.Preliminary recommendations were announced in July 2010 at the Alzheimer‟s Association International Conference on Alzheimer‟s Disease (AAICAD). These early drafts were then made available for comment on the Alzheimer‟s Association website, along with further presentation and discussion at a variety of medical and scientific meetings.The three sets of recommendations differ in terms of relevance to current clinical practice. The clinical diagnostic criteria for Alzheimer‟s dementia and MCI due to Alzheimer‟s are intended to guide diagnosis in the current clinical setting, such as a doctor‟s office, including settings where no access to testing for biomarkers exists.The use of biomarkers in both Alzheimer‟s dementia and MCI due to Alzheimer‟s disease is intended only for research at this time. However, some biomarkers, especially those using advanced imaging techniques, could enter clinical practice in the near future, though much remains to be learned about their utility in this setting.The recommendations of the preclinical Alzheimer‟s workgroup are intended for research purposes only, and do not have any clinical utility at this time.A fourth workgroup has been organized to examine the postmortem, pathological criteria for Alzheimer‟s. The results of their deliberations are expected to appear later in 2011.27年内首次出版发行的阿尔茨海默病诊断的新标准和指南–-研究建议检测症状前的阿尔茨海默病-新的阿尔茨海默病的定义促使研究者进行阿尔茨海默病早期的筛查和干预-2011年4月19日，以阿尔茨海默病协会和国立卫生院(NIH)的国家老年研究所(NIA)为先锋的三个专家工作组在芝加哥于27年内首次发布了诊断阿尔茨海默病的新标准和指南。
The disease of nervous cell
The disease of nervous cell-----Alzheimer's diseaseThe report is about a type of nervous cell disease that related to it.One of the hallmarks of Alzheimer's disease is the accumulation of amyloid between nerve cells in the brain. Amyloid is a general term for protein fragments that the body produces normally. In a healthy brain, these protein fragments would break down and be eliminated. In Alzheimer's disease, the fragments accumulate to form hard, insoluble plaquet.Tangles are insoluble twisted fibers found inside the brain's nerve cells. They primarily consist of a protein called tau, which forms part of a structure called a microtubule. The microtubule helps transport nutrients and other important substances from one part of the nerve cell to another. Axons are long threadlike extensions that conduct nerve impulses away from the nerve cell; dentrites are short branched threadlike extensions that conduct nerve impulses towards the nerve cell body. In Alzheimer's disease the tau protein is abnormal and the microtubule structures collapse.As Alzheimer’s disease progresses, brain tissue shrinks. However, the ventricles chambers within the brain that contain cerebrospinal fluid, are noticeably enlarged. In the early stages of Alzheimer's disease, short-term memory begins to decline when the cells in the hippocampus degenerate. Those with the disease lose the ability to perform routine tasks. As Alzheimer's disease spreads through the cerebral cortex (the outer layer of the brain), judgment worsens, emotional outbursts may occur and language is impaired. Advancement of the disease leads to the death of more nerve cells and subsequent changes in behaviour, such as wandering and agitation. In the final stages, people may lose the ability to feedthemselves, speak, recognize people and control bodily functions. Memory worsens and may become almost non-existent. Constant care is typically necessary. On average, those with Alzheimer’s live for 8 to 10 years after diagnosis, but this terminal disease can last for as long as 20 years.Referencesfrom:/ 25 April,2012。
阿兹海默症英语作文
阿兹海默症英语作文Alzheimer's disease, named after German physician Alois Alzheimer, is a progressive neurodegenerative disorder that affects memory, thinking, and behavior. It is a silent thief, slowly robbing individuals of their cognitive abilities, often without any outward signs until the later stages. As the disease progresses, patients may experience difficulty with day-to-day activities, such as eating, bathing, and dressing, ultimately leading to a complete dependency on others for care.The prevalence of Alzheimer's disease is increasing worldwide, particularly in developed countries where the aging population is on the rise. This trend is expected to continue as life expectancies increase and more people live into their later years. The impact of Alzheimer's disease is not limited to the patients themselves; it also has a profound effect on their families and caregivers, who often face emotional, physical, and financial burdens.The symptoms of Alzheimer's disease vary from person to person, but some common signs include memory loss, confusion, language difficulties, mood changes, andimpaired judgment. As the disease progresses, these symptoms become more severe, and patients may experience delusions, hallucinations, and even loss of physical functions. There is currently no cure for Alzheimer's disease, and treatment options are limited to managing symptoms and improving quality of life.The cause of Alzheimer's disease is still not fully understood, but research suggests that it may be caused by a combination of genetic, environmental, and lifestyle factors. While genetics play a role in determining a person's risk of developing the disease, environmental factors such as diet, exercise, and social interaction may also influence its development. Therefore, preventing Alzheimer's disease is a complex task that requires a multifaceted approach.In terms of prevention, maintaining a healthy lifestyle is crucial. This includes eating a balanced diet, staying physically active, and engaging in social activities that stimulate the brain. Additionally, maintaining cognitive fitness through activities like reading, writing, andlearning new skills can help delay the onset of Alzheimer's disease.For those who are already affected by Alzheimer's disease, support and care are essential. This includes providing a safe and secure environment, assisting with daily activities, and offering emotional support. Caregivers should also seek respite care and support groups to help them cope with the stress and burden of caring for a person with Alzheimer's disease.In conclusion, Alzheimer's disease is a growing challenge in modern society. Its impact is felt not only by the patients themselves but also by their families and caregivers. By understanding the disease, its symptoms, and its causes, we can take steps to prevent its development and provide better support and care for those who are affected. While there is currently no cure for Alzheimer's disease, through research and innovation, we hope to find better ways to manage its symptoms and improve the quality of life for those who are living with it.**阿尔茨海默症：现代社会日益严峻的挑战**阿尔茨海默症，以德国医生阿洛伊斯·阿尔茨海默命名，是一种进行性神经退行性疾病，影响记忆、思维和行为。
英语作文 战胜疾病
When faced with illness,the journey to recovery is often as much a mental battle as it is a physical one.This essay will delve into the various aspects of overcoming disease, from the initial diagnosis to the final stages of rehabilitation.The Initial DiagnosisThe first step in the battle against disease is acknowledging its presence.Upon receiving a diagnosis,it is common to experience a range of emotions,from fear and denial to acceptance and determination.The key is to quickly transition from the initial shock to a proactive mindset.This involves educating oneself about the disease,understanding the treatment options,and preparing for the challenges ahead.The Treatment ProcessThe road to recovery is often paved with medical treatments,which can be both physically and emotionally taxing.It is crucial to maintain open communication with healthcare providers,asking questions and expressing concerns.This not only ensures that the patient is wellinformed but also fosters a sense of control over the situation. Adherence to the prescribed treatment plan is paramount,as deviation can lead to complications and prolong the recovery process.The Role of Support SystemsFamily,friends,and even online communities can provide invaluable support during illness.Emotional support can help alleviate the stress and anxiety that often accompany serious health issues.Moreover,practical support,such as assistance with daily tasks or transportation to medical appointments,can be a lifeline for those who are unable to manage these responsibilities on their own.Mental Health and Coping MechanismsThe psychological impact of illness should not be underestimated.It is essential to address mental health concerns,such as depression and anxiety,which can arise during the course of treatment.Engaging in activities that promote mental wellbeing,such as meditation,yoga,or therapy,can be beneficial.Additionally,maintaining a positive outlook and focusing on personal strengths can help in building resilience.Lifestyle Changes and RehabilitationAs the body begins to heal,it is often necessary to make lifestyle adjustments to supportrecovery.This may include dietary changes,physical therapy,or adopting a new exercise regimen.Rehabilitation is a gradual process that requires patience and perseverance.It is important to set realistic goals and celebrate small victories along the way.The Final Stages of RecoveryThe journey to health is not linear,and setbacks are common.It is crucial to remain flexible and adapt to changes in the recovery process.As the patient nears the end of their treatment,they may begin to reintegrate into their preillness life.This can be a challenging transition,as they may need to navigate new limitations or a changed sense of self.ConclusionOvercoming disease is a testament to the human spirits resilience.It is a journey that requires physical strength,mental fortitude,and the support of a strong community.By focusing on education,communication,and selfcare,individuals can navigate the complexities of illness and emerge stronger on the other side.Remember,each step forward,no matter how small,is a victory in the battle against disease.。
脑部疾病的英文作文
脑部疾病的英文作文英文，Brain diseases are a serious health concern that can affect people of all ages. These diseases can cause a wide range of symptoms, such as memory loss, difficulty speaking or understanding language, and changes in mood or behavior. Some common brain diseases include Alzheimer's disease, Parkinson's disease, and multiple sclerosis.One of the most challenging aspects of brain diseases is the lack of effective treatments. While there are medications and therapies that can help manage symptoms, there is currently no cure for most brain diseases. This means that people with these conditions often have to rely on support from family and friends, as well as healthcare professionals.Another challenge with brain diseases is the stigmathat can be associated with them. People with these conditions may be seen as "crazy" or "unpredictable," which can lead to discrimination and isolation. It's important toremember that brain diseases are medical conditions, just like any other illness, and people with these conditions deserve compassion and understanding.In my own experience, I have seen the devastating effects of brain diseases on family members and friends. My grandfather had Alzheimer's disease, and watching him slowly lose his memories and abilities was heartbreaking. My friend's mother has multiple sclerosis, and seeing her struggle with the physical and emotional toll of the disease has been difficult.Despite the challenges associated with brain diseases, there is hope for the future. Research is ongoing to better understand these conditions and develop new treatments. In the meantime, it's important to support those with brain diseases and work to reduce the stigma surrounding these conditions.中文，脑部疾病是一种严重的健康问题，可能影响各个年龄段的人。
阿兹海默症英语作文
阿兹海默症英语作文Title: Understanding Alzheimer's Disease.Alzheimer's disease is a progressive neurological disorder that affects the brain, leading to memory loss, cognitive decline, and changes in behavior. It is the most common form of dementia, affecting millions of people worldwide. As a caregiver, it is important to understand the challenges faced by individuals with Alzheimer's disease and provide them with the support and care they need.One of the key symptoms of Alzheimer's disease is memory loss, which can range from forgetting recent events to not recognizing close family members. This can be distressing for both the individual with Alzheimer's and their loved ones. As a caregiver, it is important to be patient and supportive, helping the person with Alzheimer's navigate their daily life with compassion and understanding.In addition to memory loss, individuals with Alzheimer's may also experience changes in behavior, such as confusion, agitation, and wandering. It is important to create a safe and supportive environment for them, ensuringthat they are not at risk of harm. Establishing routines and providing reassurance can help reduce anxiety and improve the quality of life for individuals with Alzheimer's.Furthermore, caregivers should encourage social interactions and engagement to help stimulate cognitive function and maintain a sense of connection with others. Activities such as music therapy, art therapy, and reminiscence therapy can be beneficial in improving mood and cognitive abilities in individuals with Alzheimer's.In conclusion, Alzheimer's disease presents unique challenges for both individuals with the condition and their caregivers. By understanding the symptoms and providing compassionate care and support, caregivers can help improve the quality of life for those affected by Alzheimer's disease.中文翻译：阿兹海默症。
阿尔兹海默症英语作文
阿尔兹海默症英语作文Alzheimer's Disease: A Profound Challenge to HumanityAlzheimer's disease is a devastating neurodegenerative disorder that has become one of the most pressing public health concerns of our time. As the global population continues to age, the prevalence of this debilitating condition is on the rise, posing a significant challenge to individuals, families, and healthcare systems around the world. Understanding the complexities of Alzheimer's disease and exploring effective strategies for prevention, treatment, and care are crucial in addressing this formidable challenge.At its core, Alzheimer's disease is characterized by the progressive deterioration of cognitive functions, including memory, language, and problem-solving abilities. The hallmark of the disease is the accumulation of abnormal proteins, such as amyloid-beta and tau, which lead to the destruction of brain cells and the disruption of neural pathways. As the disease progresses, individuals with Alzheimer's experience increasing difficulty in performing everyday tasks, eventually becoming dependent on others for their basic needs.The impact of Alzheimer's disease extends far beyond the individual patient. Families and caregivers often bear the brunt of the emotional, physical, and financial burdens associated with the disease. The constant need for care and support can be overwhelming, placing a significant strain on both personal and societal resources. The emotional toll on loved ones is immense, as they witness the gradual decline of a once vibrant and independent individual.Moreover, the societal implications of Alzheimer's disease are profound. The global cost of caring for individuals with Alzheimer's and other dementias is estimated to be in the trillions of dollars, placing a heavy burden on healthcare systems and economies worldwide. The loss of productivity and the need for specialized care facilities further exacerbate the economic impact of the disease.Despite the significant challenges posed by Alzheimer's, there is reason for hope. Ongoing research has shed light on the underlying mechanisms of the disease, paving the way for the development of new and innovative treatments. Advances in early detection and diagnosis have also improved the ability to identify the disease in its earliest stages, allowing for more effective interventions.One promising area of research is the exploration of lifestyle factors that may contribute to the prevention or delay of Alzheimer's disease.Studies have suggested that a healthy diet, regular physical activity, cognitive stimulation, and social engagement may help to maintain cognitive function and reduce the risk of developing the disease. By empowering individuals to adopt these positive lifestyle changes, we can potentially mitigate the impact of Alzheimer's on both personal and societal levels.In addition to preventive measures, the search for effective treatments continues. Researchers are investigating a range of therapeutic approaches, including the targeting of amyloid-beta and tau proteins, the modulation of inflammatory pathways, and the use of stem cell therapies. While the development of a cure remains elusive, the progress made in understanding the underlying mechanisms of Alzheimer's disease has fueled hope for more effective interventions in the future.Alongside the scientific and medical efforts, the role of caregiving and support services cannot be overstated. Providing comprehensive and compassionate care for individuals with Alzheimer's and their families is essential. This includes the development of specialized memory care facilities, the training of healthcare professionals, and the expansion of community-based support programs. By addressing the multifaceted needs of those affected by Alzheimer's, we can strive to improve the quality of life for both patients and their loved ones.In conclusion, Alzheimer's disease represents a profound challenge to humanity, one that requires a multifaceted and collaborative approach to address. Through continued research, the implementation of preventive strategies, the development of effective treatments, and the provision of comprehensive care and support, we can work towards a future where the burden of Alzheimer's is significantly reduced. By embracing this challenge with determination and compassion, we can honor the dignity and humanity of those affected by this devastating disease and strive to create a more inclusive and supportive world for all.。
alzheimer英语阅读理解
alzheimer英语阅读理解Alzheimer's disease is a progressive neurological disorder that affects memory and other cognitive functions. It is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 60-80% of dementia cases.The exact cause of Alzheimer's disease is not yet fully understood, but it is believed to be a combination of genetic, environmental, and lifestyle factors. The hallmark of Alzheimer's disease is the accumulation of abnormal protein deposits in the brain, known as amyloid plaques and tau tangles, which interfere with the communication between brain cells and eventually lead to their death.The symptoms of Alzheimer's disease typically develop slowly and worsen over time. Early signs may include difficulty remembering newly learned information, disorientation, and changes in behavior. As the diseaseprogresses, individuals may experience problems with speaking, swallowing, and walking. Eventually, they may lose the ability to carry on a conversation and respond to their environment.Diagnosis of Alzheimer's disease involves a comprehensive medical evaluation, including a thorough medical history, physical and neurological exams, and various cognitive tests. While there is currently no cure for Alzheimer's disease, early diagnosis can help individuals and their families plan for the future and access available treatments to manage symptoms.Treatment for Alzheimer's disease focuses on managing symptoms and providing support to improve the quality of life for affected individuals. This may involve medications to temporarily improve cognitive and behavioral symptoms, as well as non-drug approaches such as cognitive stimulation, physical exercise, and social engagement.In conclusion, Alzheimer's disease is a complex and challenging condition that affects millions of individualsworldwide. It is important to continue research efforts to better understand the disease, develop effective treatments, and ultimately find a cure. Additionally, raising awareness and providing support for individuals and families affected by Alzheimer's disease is crucial in improving theirquality of life.。
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STATE OF THE ART REVIEW
E DISEASE
Alzheimer’s Disease: The Challenge of the Second Century
David M. Holtzman,1,2,3,4* John C. Morris,1,3,4,5 Alison M. Goate1,3,4,6
Studies of AD molecular pathology provided the findings that guided geneticists in the late 1980s to important initial discoveries. In turn, the basic understanding of AD started with the identification of genetic changes and their associated cellular and molecular consequences that either are causative or alter risk of developing AD. Current and future genetic studies may lead to new insights into pathogenesis and therapeutic targets by gene identification using state-of-the-art genomic techniques combined with biomarkers. AD is thought to be a disorder of protein aggregation in which the aggregation and accumulation in the brain of two proteins, b amyloid (Ab) and tau, are key players in AD pathophysiology. However, there are many additional cellular pathways, processes, and molecules involved in AD pathogenesis that have emerged and will continue to be discovered, which play important roles in the disease. A key insight that is changing diagnostic and therapeutic approaches to AD is that pathological changes that underlie the brain degeneration and cognitive loss seen in patients with AD begin at least 10 to 20 years before de-
mentia onset. Recent advances in the identification of biomarkers of AD have already made it possible to detect aspects of AD pathology in cognitively normal individuals such as Ab deposition and neurodegeneration. With scientific advances, promising potential therapies are being developed, but these therapies are not yet being tested in attempts to delay the onset or prevent the cognitive symptoms from appearing. A major challenge for the field will be to identify patient populations at high risk for converting from cognitively normal to impaired over a 3- to 4-year window and to target this population for clinical trials. It will be necessary to change the way we design clinical trials and incorporate the wealth of pathophysiological, genetic, and biomarker data to identify such high-risk populations and to target them with mechanistically based therapies to have a reasonable chance to make a real impact on this devastating disorder.
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OVERVIEW
Alois Alzheimer, a German psychiatrist, reported at a meeting in Tübingen, Germany, in 1906 his clinicopathological study of a woman who presented with a “peculiar” dementia at age 51 years. Alzheimer correlated the woman’s cognitive and behavioral features with histopathological findings of “miliary foci” and neurofibrillary change in the cerebral cortex after her death at 55 years (1). In the 105 years since Alzheimer’s original case report and particularly in the past three decades, much has been learned about Alzheimer’s disease (AD). In this review, we will describe the clinical and pathological features of AD and highlight its importance as a global public health problem of immense proportions, both today and in decades to come. We will also discuss the challenges in translating scientific findings into new treatments to improve cognitive function, slow progression, delay onset, and prevent AD.
Alzheimer’s disease (AD) was first described a little more than 100 years ago. It is the most common cause of dementia with an estimated prevalence of 30 million people worldwide, a number that is expected to quadruple in 40 years. There currently is no effective treatment that delays the onset or slows the progression of AD. However, major scientific advances in the areas of genetics, biochemistry, cell biology, and neuroscience over the past 25 years have changed the way we think about AD. This review discusses some of the challenges to translating these basic molecular and cellular discoveries into clinical therapies. Current information suggests that if the disease is detected before the onset of overt symptoms, it is possible that treatments based on knowledge of underlying pathogenesis can and will be effective.