Primer

Alzheimer's disease

  • Nature Reviews Disease Primers 1, Article number: 15056 (2015)
  • doi:10.1038/nrdp.2015.56
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Abstract

Alzheimer's disease is a chronic illness with long preclinical and prodromal phases (20 years) and an average clinical duration of 8–10 years. The disease has an estimated prevalence of 10–30% in the population >65 years of age with an incidence of 1–3%. Most patients with Alzheimer's disease (>95%) have the sporadic form, which is characterized by a late onset (80–90 years of age), and is the consequence of the failure to clear the amyloid-β (Aβ) peptide from the interstices of the brain. A large number of genetic risk factors for sporadic disease have been identified. A small proportion of patients (<1%) have inherited mutations in genes that affect processing of Aβ and develop the disease at a much younger age (mean age of 45 years). Detection of the accumulation of Aβ is now possible in preclinical and prodromal phases using cerebrospinal fluid biomarkers and PET. Several approved drugs ameliorate some of the symptoms of Alzheimer's disease, but no current interventions can modify the underlying disease mechanisms. Management is focused on the support of the social networks surrounding the patient and the treatment of any co-morbid illnesses, such as cerebrovascular disease.

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Author information

Affiliations

  1. The Florey Institute of Neuroscience and Mental Health, University of Melbourne, 30 Royal Parade, Parkville, Victoria 3010, Australia.

    • Colin L. Masters
  2. School of Medicine, Washington University, St. Louis, Missouri, USA.

    • Randall Bateman
  3. Clinical Neurochemistry Laboratory, Department of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Gothenburg, Sweden.

    • Kaj Blennow
  4. Molecular Imaging Research, Austin Health, Melbourne, Australia.

    • Christopher C. Rowe
  5. Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.

    • Reisa A. Sperling
  6. Massachusetts General Hospital Memory Disorders Unit, Boston, Massachusetts, USA.

    • Reisa A. Sperling
  7. Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, Nevada, USA.

    • Jeffrey L. Cummings

Authors

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Contributions

Introduction (C.L.M.); Epidemiology (C.L.M.); Mechanisms/pathophysiology (R.B.); Diagnosis, screening and prevention (K.B., C.C.R. and R.A.S.); Management (J.L.C.); Quality of life (J.L.C.); Outlook (C.L.M.); Overview of the Primer (C.L.M.).

Competing interests

C.L.M. has provided consultation to Eli Lilly, Actinogen and Prana Biotechnology. He has stock ownership in Prana Biotechnology. R.B. has provided consultation to FORUM, Merck, Roche, Sanofi, Boehringer Ingelheim and Eli Lilly. He currently consults and owns stock in C2N Diagnostics, which he co-founded. He also receives research support from Eli Lilly, Roche, Merck and the Dominantly Inherited Alzheimer Network (DIAN) Pharma Consortium (comprising Amgen, Biogen Idec, Eisai, FORUM, Genentech, Janssen, Lilly, Roche and Sanofi). K.B. has served on advisory boards for Amgen, Eli Lilly, IBL International, Novartis, Roche Diagnostics and Sanofi-Aventis. C.C.R. has received research grants from GE Healthcare, Avid Radiopharmaceuticals, Primal, AstraZeneca and Navidea in the past 2 years. R.A.S. has served as a consultant for Janssen, Genentech, ISIS Pharmaceuticals and Roche. She receives research support from Eli Lilly and Janssen. J.L.C. has provided consultation to AbbVie, Acadia, Actinogen, ADAMAS, Alzheon, Anavex, Avanir, Biogen Idec, Biotie, Boehinger Ingelheim, Chase, Eisai, FORUM, Genentech, Grifols, Intracellular Therapies, Eli Lilly, Lundbeck, Merck, Neurotrope, Novartis, Nutricia, Otsuka, Pfizer, Resverlogix, Roche, Roivant, Suven, Takeda and Toyoma companies.

Corresponding author

Correspondence to Colin L. Masters.