Alzheimer's disease classification: Difference between revisions
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Major deficits | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Major deficits | ||
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|Predementia | |'''Predementia''' | ||
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* Difficulty remembering recently learned facts and acquiring new information | * Difficulty remembering recently learned facts and acquiring new information | ||
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* Mild [[cognitive impairment]] | * Mild [[cognitive impairment]] | ||
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|Early dementia | |'''Early dementia''' | ||
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* Impairment of [[learning]] and [[memory]] | * Impairment of [[learning]] and [[memory]] | ||
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* Noticeable cognitive impairment | * Noticeable cognitive impairment | ||
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|Moderate dementia | |'''Moderate dementia''' | ||
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* Speech disturbance ([[paraphasia]]) | * Speech disturbance ([[paraphasia]]) | ||
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** [[Urinary incontinence]] | ** [[Urinary incontinence]] | ||
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|Advanced dementia | |'''Advanced dementia''' | ||
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* Language is reduced to simple phrases or even single words, eventually leading to complete loss of speech | * Language is reduced to simple phrases or even single words, eventually leading to complete loss of speech | ||
Revision as of 20:33, 21 September 2017
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Alzheimer's disease Microchapters |
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Diagnosis |
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Treatment |
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Alzheimer's disease classification On the Web |
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American Roentgen Ray Society Images of Alzheimer's disease classification |
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Risk calculators and risk factors for Alzheimer's disease classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2], Aravind Reddy Kothagadi M.B.B.S[3], Haleigh Williams, B.S.
Overview
Alzheimer's disease may be classified according to severity into mild, moderate and severe dementia. It may also be classified based on age of onset into early onset and late onset Alzheimer's disease. Another method of classification of Alzheimer's disease is based on the course of disease into pre-dementia, early dementia, moderate dementia and advanced dementia.
Classification
Classification based on severity
Alzheimer's disease may be classified based on the clinical dementia rating criteria into minimal, intermediate, mild, moderate and severe:
| Clinical Dementia Rating | |||||
| Based on the severity of Impairment | |||||
| Criteria | Minimal | Indeterminate | Mild | Moderate | Severe |
|---|---|---|---|---|---|
| Memory | No memory loss or slight forgetfulness | Minimal forgetfulness; partial recollection of events; “benign” forgetfulness | Moderate memory loss; more marked for recent events; defect interferes with everyday activities | Severe memory loss; only highly learned material retained; new material rapidly lost | Severe memory loss; only fragments remain |
| Orientation | Fully oriented | Fully oriented except for slight difficulty with time perception | Moderate difficulty with time perception; oriented for place at examination; may be disoriented to place | Severe difficulty with time relationships; usually disoriented to time, often to place | Oriented to person only |
| Judgment and problem solving | Able to handle daily life activities (including financial issues); judgment good in relation to past performance | Mild impairment in solving problems, determining similarities and differences | Moderate difficulty in solving problems, difficulty in distinguishing things; social judgment usually maintained | Severely impaired in solving problems, determining similarities and differences; social judgment usually impaired | Unable to make judgments or solve problems |
| Social functioning | Functions independently and performs daily tasks such as shopping, and volunteer and social groups | Slight impairment in performing social activities | Unable to perform social activities, although may still be engaged in some; appears normal on casual observation | No pretense of independent function outside of home; appears well enough to be taken to functions outside a family home | No pretense of independent function outside of home; appears too ill to be taken to functions outside a family home |
| Home and hobbies | Able to carry out daily life activities, hobbies, and intellectual interests well maintained | Daily life tasks, hobbies, and intellect slightly impaired | Mild but definite impairment of function in performing daily life tasks; more difficult chores abandoned; more complicated hobbies and interests abandoned | Only simple chores preserved; interests very restricted and poorly maintained | No significant function in home |
| Personal care | Able to take care of self | Fully functional | Needs reminders | Requires assistance in dressing, hygiene, keeping of personal effects | Requires much help with personal care; frequent incontinence |
Classification based on age of onset
Alzheimer's disease may be classified into early onset and late onset based on age of onset:[1][2][3][4][5]
| Sub-class | Genetics | Prevalence |
|---|---|---|
| Late-onset familial (AD2) | 15%-25% of familial cases | |
| Early-onset familial AD (AD1, AD3, AD4) |
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<2% of familial cases |
Classification based on course of disease
Alzheimer's disease may be classified into the following stages based on course of disease:[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][14][22][23][24][25][26][27][28][29][30]
| Stage of Alzheime's disease | Major deficits |
|---|---|
| Predementia |
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| Early dementia |
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| Moderate dementia |
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| Advanced dementia |
References
- ↑ "Alzheimer Disease Overview - GeneReviews® - NCBI Bookshelf".
- ↑ Brickell KL, Steinbart EJ, Rumbaugh M, Payami H, Schellenberg GD, Van Deerlin V, Yuan W, Bird TD (2006). "Early-onset Alzheimer disease in families with late-onset Alzheimer disease: a potential important subtype of familial Alzheimer disease". Arch. Neurol. 63 (9): 1307–11. doi:10.1001/archneur.63.9.1307. PMID 16966510.
- ↑ Campion D, Dumanchin C, Hannequin D, Dubois B, Belliard S, Puel M, Thomas-Anterion C, Michon A, Martin C, Charbonnier F, Raux G, Camuzat A, Penet C, Mesnage V, Martinez M, Clerget-Darpoux F, Brice A, Frebourg T (1999). "Early-onset autosomal dominant Alzheimer disease: prevalence, genetic heterogeneity, and mutation spectrum". Am. J. Hum. Genet. 65 (3): 664–70. doi:10.1086/302553. PMC 1377972. PMID 10441572.
- ↑ Munoz DG, Feldman H (2000). "Causes of Alzheimer's disease". CMAJ. 162 (1): 65–72. PMC 1232234. PMID 11216203.
- ↑ Hölscher C (1998). "Possible causes of Alzheimer's disease: amyloid fragments, free radicals, and calcium homeostasis". Neurobiol. Dis. 5 (3): 129–41. doi:10.1006/nbdi.1998.0193. PMID 9848086.
- ↑ Volicer L, Harper DG, Manning BC, Goldstein R, Satlin A. "Sundowning and circadian rhythms in Alzheimer's disease". Am J Psychiatry. 158 (5): 704–11. PMID 11329390. Retrieved 2008-08-27.
- ↑ Arnáiz E, Almkvist O (2003). "Neuropsychological features of mild cognitive impairment and preclinical Alzheimer's disease". Acta Neurol. Scand., Suppl. 179: 34–41. doi:10.1034/j.1600-0404.107.s179.7.x. PMID 12603249.
|access-date=requires|url=(help) - ↑ Kazui H, Matsuda A, Hirono N; et al. (2005). "Everyday memory impairment of patients with mild cognitive impairment". Dement Geriatr Cogn Disord. 19 (5–6): 331–7. doi:10.1159/000084559. PMID 15785034. Retrieved 2008-06-12.
- ↑ Rapp MA, Reischies FM (2005). "Attention and executive control predict Alzheimer disease in late life: results from the Berlin Aging Study (BASE)". American Journal of Geriatric Psychiatry. 13 (2): 134–141. doi:10.1176/appi.ajgp.13.2.134. PMID 15703322.
- ↑ Spaan PE, Raaijmakers JG, Jonker C (2003). "Alzheimer's disease versus normal ageing: a review of the efficiency of clinical and experimental memory measures". Journal of Clinical Experimental Neuropsychology. 25 (2): 216–233. PMID 12754679.
- ↑ Craig D, Mirakhur A, Hart DJ, McIlroy SP, Passmore AP (2005). "A cross-sectional study of neuropsychiatric symptoms in 435 patients with Alzheimer's disease". American Journal of Geriatric Psychiatry. 13 (6): 460–468. doi:10.1176/appi.ajgp.13.6.460. PMID 15956265.
- ↑ Robert PH, Berr C, Volteau M, Bertogliati C, Benoit M, Sarazin M, Legrain S, Dubois B (2006). "Apathy in patients with mild cognitive impairment and the risk of developing dementia of Alzheimer's disease: a one-year follow-up study". Clin Neurol Neurosurg. 108 (8): 733–736. doi:10.1016/j.clineuro.2006.02.003. PMID 16567037.
- ↑ Palmer K, Berger AK, Monastero R, Winblad B, Bäckman L, Fratiglioni L (2007). "Predictors of progression from mild cognitive impairment to Alzheimer disease". Neurology. 68 (19): 1596–1602. doi:10.1212/01.wnl.0000260968.92345.3f. PMID 17485646.
- ↑ 14.0 14.1 Förstl H, Kurz A (1999). "Clinical features of Alzheimer's disease". European Archives of Psychiatry and Clinical Neuroscience. 249 (6): 288–290. PMID 10653284.
- ↑ Small BJ, Gagnon E, Robinson B. "Early identification of cognitive deficits: preclinical Alzheimer's disease and mild cognitive impairment". Geriatrics. 62 (4): 19–23. PMID 17408315.
- ↑ Petersen RC. "The current status of mild cognitive impairment—what do we tell our patients?". Nat Clin Pract Neurol. 3 (2): 60–1. doi:10.1038/ncpneuro0402. PMID 17279076.
- ↑ Frank EM. "Effect of Alzheimer's disease on communication function". J S C Med Assoc. 90 (9): 417–23. PMID 7967534.
- ↑ Jelicic M, Bonebakker AE, Bonke B (1995). "Implicit memory performance of patients with Alzheimer's disease: a brief review". International Psychogeriatrics. 7 (3): 385–392. doi:10.1017/S1041610295002134. PMID 8821346.
- ↑ Becker JT, Overman AA (2002). "[The semantic memory deficit in Alzheimer's disease]". Rev Neurol (in Spanish; Castilian). 35 (8): 777–83. PMID 12402233.
- ↑ Hodges JR, Patterson K. "Is semantic memory consistently impaired early in the course of Alzheimer's disease? Neuroanatomical and diagnostic implications". Neuropsychologia. 33 (4): 441–59. PMID 7617154.
- ↑ Benke T. "Two forms of apraxia in Alzheimer's disease". Cortex. 29 (4): 715–25. PMID 8124945.
- ↑ Forbes KE, Shanks MF, Venneri A. "The evolution of dysgraphia in Alzheimer's disease". Brain Res. Bull. 63 (1): 19–24. doi:10.1016/j.brainresbull.2003.11.005. PMID 15121235.
- ↑ Galasko D, Schmitt F, Thomas R, Jin S, Bennett D (2005). "Detailed assessment of activities of daily living in moderate to severe Alzheimer's disease". Journal of the International Neuropsychology Society. 11 (4): 446–453. PMID 16209425.
- ↑ Neuropsychiatric symptoms:
- Scarmeas N, Brandt J, Blacker D; et al. "Disruptive behavior as a predictor in Alzheimer disease". Arch. Neurol. 64 (12): 1755–61. doi:10.1001/archneur.64.12.1755. PMID 18071039.
- Tatsch MF, Bottino CM, Azevedo D; et al. "Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity". Am J Geriatr Psychiatry. 14 (5): 438–45. doi:10.1097/01.JGP.0000218218.47279.db. PMID 16670248.
- Volicer L, Bass EA, Luther SL. "Agitation and resistiveness to care are two separate behavioral syndromes of dementia". J Am Med Dir Assoc. 8 (8): 527–32. doi:10.1016/j.jamda.2007.05.005. PMID 17931577.
- ↑ Honig LS, Mayeux R. "Natural history of Alzheimer's disease". Aging (Milano). 13 (3): 171–82. PMID 11442300.
- ↑ Gold DP, Reis MF, Markiewicz D, Andres D. "When home caregiving ends: a longitudinal study of outcomes for caregivers of relatives with dementia". J Am Geriatr Soc. 43 (1): 10–6. PMID 7806732.
- ↑ Souren LE, Franssen EH, Reisberg B. "Contractures and loss of function in patients with Alzheimer's disease". J Am Geriatr Soc. 43 (6): 650–5. PMID 7775724.
- ↑ Wada H, Nakajoh K, Satoh-Nakagawa T; et al. "Risk factors of aspiration pneumonia in Alzheimer's disease patients". Gerontology. 47 (5): 271–6. PMID 11490146.
- ↑ Berkhout AM, Cools HJ, van Houwelingen HC. "The relationship between difficulties in feeding oneself and loss of weight in nursing-home patients with dementia". Age Ageing. 27 (5): 637–41. PMID 12675103.
- ↑ Gambassi G, Landi F, Lapane KL, Sgadari A, Mor V, Bernabei R. "Predictors of mortality in patients with Alzheimer's disease living in nursing homes". J. Neurol. Neurosurg. Psychiatr. 67 (1): 59–65. PMC 1736445. PMID 10369823.