Alzheimer Disease
It is the most common cause of dementia, which is an acquired cognitive and behavioral impairment of sufficient severity to interfere significantly with social and occupational functioning. At present, the disorder afflicts approximately 5 million people in the United States and more than 30 million people worldwide. A larger number of individuals have lesser levels of cognitive impairment, which frequently evolve into a full-blown dementia, thereby increasing the number of affected persons. Prevalence of this disorder is expected to increase substantially in this century, since the disorder preferentially affects the elderly, who constitute the fastest growing age bracket in many countries, especially in industrialized nations. For example, statistical projections indicate that the number of persons affected by the disorder in the United States will nearly triple by the year 2050.
AD most commonly presents with insidiously progressive memory loss, to which other spheres of cognitive impairment are added over the course of several years. Functions commonly affected after the development of memory loss include language disorders (e.g., anomia, progressive aphasia) and impaired visuospatial skills and executive functions. Substantially rarer presentations include right parietal lobe syndrome, progressive aphasia, spastic paraparesis, and impaired visuospatial skills, subsumed under the so-called visual variant of AD. These latter, unusual presentations often present a diagnostic challenge, since they are not covered under the guidelines for the clinical diagnosis of the disease. Therefore, their diagnosis necessitates histopathologic confirmation or is made at the time of autopsy, disconfirming previous diagnoses (e.g., primary progressive aphasia, cerebrovascular conditions, prion disorders) made on purely clinical grounds.