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'''Alzheimer's disease''' ('''AD'''), also known as '''Alzheimer disease''', or just '''Alzheimer's''', accounts for 60% to 70% of cases of [[dementia]].<ref name=BMJ2009/><ref name=WHO2014/> It is a chronic [[neurodegeneration|neurodegenerative]] disease that usually starts slowly and gets worse over time.<ref name=BMJ2009/><ref name=WHO2014/> The most common early symptom is difficulty in remembering recent events ([[short-term memory]] loss).<ref name=BMJ2009>{{cite journal|last1=Burns|first1=A|last2=Iliffe|first2=S|title=Alzheimer's disease.|journal=BMJ (Clinical researchResearch edEd.)|date=5 February 2009|volume=338|pages=b158|pmid=19196745|doi=10.1136/bmj.b158}}</ref> As the disease advances, symptoms can include: [[primary progressive aphasia |problems with language]], [[disorientation]] (including easily getting lost), [[mood swing]]s, loss of [[motivation]], not managing [[Activities of daily living|self care]], and [[challenging behaviour|behavioural issues]].<ref name=WHO2014/><ref name=BMJ2009/> As a person's condition declines, she or he often withdraws from family and society.<ref name=BMJ2009/> Gradually, bodily functions are lost, ultimately leading to death.<ref name="nihstages">{{cite web|title=About Alzheimer's Disease: Symptoms|url=http://www.nia.nih.gov/alzheimers/topics/symptoms|publisher=National Institute on Aging|accessdate=28 December 2011}}</ref> Although the speed of progression can vary, the average life expectancy following diagnosis is three to nine years.<ref name=NEJM2010/><ref>{{cite journal|last1=Todd|first1=S|last2=Barr|first2=S|last3=Roberts|first3=M|last4=Passmore|first4=AP|title=Survival in dementia and predictors of mortality: a review.|journal=International journalJournal of geriatricGeriatric psychiatryPsychiatry|date=November 2013|volume=28|issue=11|pages=1109-241109–24|pmid=23526458|doi=10.1002/gps.3946}}</ref>
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The cause of Alzheimer's disease is poorly understood.<ref name=BMJ2009/> About 70% of the risk is believed to be [[heredity|genetic]] with many [[gene]]s usually involved.<ref name=Lancet2011/> Other risk factors include: a history of [[head injury|head injuries]], [[major depressive disorder|depression]] or [[hypertension]].<ref name=BMJ2009/> The disease process is associated with [[Senile plaques|plaques]] and [[Neurofibrillary tangle|tangles]] in the [[brain]].<ref name=Lancet2011>{{cite journal|last1=Ballard|first1=C|last2=Gauthier|first2=S|last3=Corbett|first3=A|last4=Brayne|first4=C|last5=Aarsland|first5=D|last6=Jones|first6=E|title=Alzheimer's disease.|journal=Lancet|date=19 March 2011|volume=377|issue=9770|pages=1019-311019–31|pmid=21371747|doi=10.1016/S0140-6736(10)61349-9}}</ref> A probable diagnosis is based on the history of the illness and [[cognitive testing]] with [[medical imaging]] and [[blood test]]s to rule out other possible causes.<ref>{{cite web|title=Dementia diagnosis and assessment|url=http://pathways.nice.org.uk/pathways/dementia/dementia-diagnosis-and-assessment.pdf|website=pathways.nice.org.uk|accessdate=30 November 2014}}</ref> Initial symptoms are often mistaken for normal ageing.<ref name=BMJ2009/> Examination of brain tissue is needed for a definite diagnosis.<ref name=Lancet2011/> [[Mental exercise|Mental]] and [[physical exercise]], and avoiding [[obesity]] may decrease the risk of AD.<ref name=Lancet2011/> There are no medications or supplements with evidence to support their use.<ref name="prevention1">{{cite web|title=More research needed on ways to prevent Alzheimer's, panel finds|url=http://www.nia.nih.gov/alzheimers/announcements/2010/06/more-research-needed-ways-prevent-alzheimers-panel-finds|format=PDF|publisher=National Institute on Aging|accessdate=29 February 2008|date=29 August 2006}}</ref> It is classified as a [[neurodegenerative]] disorder.<ref name=BMJ2009/>
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No treatments stop or reverse its progression, though some may temporarily improve symptoms.<ref name=WHO2014/> Affected people increasingly rely on others for assistance, often placing a burden on the [[Caring for people with dementia|caregiver]]; the pressures can include social, psychological, physical, and economic elements.<ref name="pmid17662119">{{vcitecite journal | author = Thompson CA, Spilsbury K, Hall J, Birks Y, Barnes C, Adamson J | title = Systematic Review of Information and Support Interventions for Caregivers of People with Dementia | journal = BMC Geriatrics | volume = 7 | page = 18 | year = 2007 | pmid = 17662119 | pmc = 1951962 | doi = 10.1186/1471-2318-7-18 |doi-access=free}}</ref> Exercise programs are beneficial with respect to [[activities of daily living]] and potentially improve outcomes.<ref name=Forb2013>{{cite journal|last1=Forbes|first1=D.|last2=Thiessen|first2=E.J.|last3=Blake|first3=C.M.|last4=Forbes|first4=S.C.|last5=Forbes|first5=S.|editor-first1=Catherine M. |editor-last1=Blake |title=Exercise programs for people with dementia.|journal=The Cochrane databaseDatabase of systematicSystematic reviewsReviews|date=4 December 2013|volume=12|issue=12 |pages=CD006489|pmid=24302466|doi=10.1002/14651858.CD006489.pub3}}</ref> Treatment of behavioral problems or [[psychosis]] due to dementia with [[antipsychotic]]s is common but not usually recommended due to there often being little benefit and an increased risk of early death.<ref>{{cite web|author1=National Institute for Health and Clinical Excellence|title=Low-dose antipsychotics in people with dementia|url=https://www.nice.org.uk/advice/ktt7/resources/non-guidance-lowdose-antipsychotics-in-people-with-dementia-pdf|website=nice.org.uk|accessdate=29 November 2014}}</ref><ref>{{cite web|title=Information for Healthcare Professionals: Conventional Antipsychotics|url=http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124830.htm|website=fda.gov|accessdate=29 November 2014|date=2008-06-16}}</ref>
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In 2010, there were between 21 and 35 million people worldwide with AD.<ref name=NEJM2010>{{cite journal|last1=Querfurth|first1=HW|last2=LaFerla|first2=FM|title=Alzheimer's disease.|journal=The New England Journal of Medicine|date=28 January 2010|volume=362|issue=4|pages=329-44329–44|pmid=20107219|doi=10.1056/NEJMra0909142}}</ref><ref name=WHO2014>{{cite web|title=Dementia Fact sheet N°362|url=http://www.who.int/mediacentre/factsheets/fs362/en/|website=who.int|accessdate=28 November 2014|date=April 2012}}</ref> It most often begins in people over 65 years of age, although 4% to 5% of cases are [[early-onset Alzheimer's]] which begin before this.<ref>{{cite journal|last1=Mendez|first1=MF|title=Early-onset Alzheimer's disease: nonamnestic subtypes and type 2 AD.|journal=Archives of medicalMedical researchResearch|date=November 2012|volume=43|issue=8|pages=677-85677–85|pmid=23178565|doi=10.1016/j.arcmed.2012.11.009|pmc=3532551 }}</ref> It affects about 6% of people 65 years and older.<ref name=BMJ2009/> In 2010, dementia resulted in about 486,000 deaths.<ref name=Loz2012>{{cite journal|last1=Lozano|first1=R|last2=Naghavi|first2=M|last3=Foreman|first3=K|title=Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.|journal=Lancet|date=15 December 2012|volume=380|issue=9859|pages=2095-1282095–128|pmid=23245604|doi=10.1016/S0140-6736(12)61728-0|pmc=10790329}}</ref> It was first described by, and later named after, German psychiatrist and pathologist [[Alois Alzheimer]] in 1906.<ref name="pmid9661992">{{vcitecite journal | author = Berchtold NC, Cotman CW | title = Evolution in the Conceptualization of Dementia and Alzheimer's Disease: Greco-Roman Period to the 1960s | journal = Neurobiology of Aging | volume = 19 | issue = 3 | pages = 173–89 | year = 1998 | pmid = 9661992 | doi = 10.1016/S0197-4580(98)00052-9 }}</ref> In [[developed country|developed countries]], AD is one of the most financially costly diseases.<ref name="pmid15685097">{{vcitecite journal | author = Bonin-Guillaume S, Zekry D, Giacobini E, Gold G, Michel JP | title = Impact économique de la démence (English: The Economical Impact of Dementia) | language = French | journal = Presse Médicale | volume = 34 | issue = 1 | pages = 35–41 | year = 2005 | pmid = 15685097 | issn = 0755-4982 | monthdate = January 2005 | doi = 10.1016/s0755-4982(05)83882-5 }}</ref><ref name="pmid9543467">{{vcitecite journal | author = Meek PD, McKeithan K, Schumock GT | title = Economic Considerations in Alzheimer's Disease | journal = Pharmacotherapy | volume = 18 | issue = 2 Pt 2 | pages = 68–73; discussion 79–82 | year = 1998 | doi = 10.1002/j.1875-9114.1998.tb03880.x | pmid = 9543467 }}</ref>
==References==
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