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Contempo Updates |

Alzheimer Disease

Jeffrey L. Cummings, MD; Greg Cole, PhD
JAMA. 2002;287(18):2335-2338. doi:10.1001/jama.287.18.2335.
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Alzheimer disease (AD), the most common cause of dementia in the elderly, is a progressive neurodegenerative disorder that gradually robs the patient of cognitive function and eventually causes death. We review the epidemiology, clinical features, pathophysiology, and treatment of AD.

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Figure 1. Morphology and Distribution of Neuritic Plaques and Neurofibrillary Tangles
Graphic Jump Location
A, Neuritic plaque (labeled with a monoclonal antibody for human amyloid peptide using diaminobenzidine combined with hematoxylin counterstain, × 2500 magnification). B, Distribution of neuritic plaques in the cerebral cortex. C, Neurofibrillary tangle (Gallyas silver stain; × 2500 magnification). D, Distribution of neurofibrillary tangles in the cerebral cortex.
Figure 2. Cascade of Events Associated With β-Amyloid Generation and Cell Death
Graphic Jump Location
Oligomerization of the β-amyloid peptide initiates oxidative injury, plaque formation (following β-amyloid aggregation), and possibly tangle formation (dashed line). Oxidative injury and inflammation contribute to membrane disruption, degeneration of the neuronal axon, and loss of synapses. Neurodegeneration ensues leading to cell death and neurotransmitter deficits. Apolipoprotein E, α-1-antichymotrypsin, and possibly α-2-macroglobulin contribute to plaque formation.



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