Alzheimer's Disease: Symptoms, Progression & Treatment Options

Alzheimer's disease (AD) is the most common cause of dementia (60–80% of cases). It is a progressive neurodegenerative disorder.

Core Features

• Memory impairment – Recent memory first (episodic); later remote memory.
• Cognitive deficits – Language (anomia, comprehension), executive function, visuospatial, praxis.
• Behavioral/psychiatric – Apathy, depression, anxiety, agitation, psychosis, wandering.
• Functional decline – IADLs → ADLs; eventually total dependence.

Neuropathology

• Amyloid-β plaques, neurofibrillary tangles (tau), synaptic loss, neuronal death, atrophy (hippocampus, cortex).

Stages

• Preclinical (biomarkers only)
• Mild cognitive impairment (MCI) due to AD
• Mild, moderate, severe dementia

Treatment

• Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) – Mild-moderate.
• NMDA antagonist (memantine) – Moderate-severe.
• Anti-amyloid mAbs (lecanemab, donanemab) – Early symptomatic; modest slowing, ARIA risk.
• Non-pharmacologic – Cognitive stimulation, exercise, routine, caregiver support, safety.

No cure, but early diagnosis allows planning, clinical trial access, and symptomatic management.