Alzheimer's disease.

Alzheimer's disease is an extremely prevalent illness that has been more clearly understood in recent years. Although its cause is unknown, it is in some cases genetically transmissable. Symptoms include forgetfulness, memory loss, and confusion early in the illness and culminate in loss of personality and total cognitive degeneration. Diagnosis can be made with certainty only at autopsy, but the clinician must carefully eliminate treatable and partially treatable illnesses that present as dementia. A deficit of choline acetyltransferase seems specific to the disease and has been correlated to the neuropathologic changes in brains of patients with AD as well as to clinical symptomatology. While pharmacologic treatment strategies have attempted to increase brain acetylcholine function, they have not been clinically successful to date. Antipsychotic agents remain the treatment of choice for many AD patients, although helping the family care for such patients may be the most valuable service the physician can provide.