Monday, June 21, 2010

 Changes from normal aging to preclinical Alzheimer's disease
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Impaired memory is typically one of the first signs of Alzheimer's disease, but difficulty recalling the names of friends or recent events is also common among normal elderly persons. The clinician is thus faced with the difficulty of distinguishing between normal aging and the early stages of Alzheimer's disease. Mild cognitive impairment is an intermediate state in which persons have more memory problems than would be considered normal for their age, but their symptoms are not as severe as the symptoms of Alzheimer disease and they do not have functional impairment. Alzheimer's disease develops at a much higher frequency among persons with mild cognitive impairment than among those with normal aging. Determining when patients have reached the very early stage of Alzheimer's disease is not easy, particularly because it is likely that a preclinical stage of Alzheimer's disease exists in which senile plaques, neuritic plaques, and neurofibrillary tangles occur in sufficient numbers to meet standard neuropathological criteria for Alzheimer's disease in the absence of overt symptoms or signs of dementia. Other causes of memory impairment must also be considered, such as cerebrovascular disease, hydrocephalus, hypothyroidism, vitamin B12 deficiency, central nervous system infection, a cognitive disorder related to human immunodeficiency virus infection, adverse effects of prescribed medications, substance abuse, and cancer. Read more:  content.nejm.org
   

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