Alzheimer's disease: evolving clinical concepts and management strategies.

The prevalence of Alzheimer's disease is rising dramatically. This increase results from a "graying" of our population and a redefinition of the term Alzheimer's disease. Alzheimer's disease is recognized to be a progressive neurologic disorder of unknown cause but is not associated with any increased cerebral arteriosclerosis as compared to age-matched controls. The course of the illness on average is about ten years. A variety of inclusion and exclusion criteria, if used conservatively, can accurately predict the pathologic diagnosis of Alzheimer's disease. Whereas no specific cause or clearly effective treatment is currently available, care consists of pharmacologic therapy aimed at specific symptoms and measures designed to reduce patient confusion and care-giver burden. The physician can benefit the patient and care giver by providing an accurate diagnosis, providing therapy where available, counseling the family, and providing referrals to available community-support services.