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Alzheimer's Disease (AD) is the most common cause of dementia affecting millions of individuals worldwide. It is characterized by the accumulation of amyloid-beta plaques and tau tangles in the brain leading to progressive neuronal damage and cognitive decline. The clinical manifestations of AD typically include memory loss, language difficulties, impaired judgment and changes in behavior and personality. Alzheimer's Disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment and functional disability. The study presents the clinical course, diagnostic challenges, treatment strategies and caregiver burden of a patient diagnosed with AD. The study highlights the importance of early detection, multidisciplinary management and support for caregivers in optimizing patient outcomes and enhancing quality of life.

Treatment strategies

Currently there is no cure for Alzheimer's disease and available treatments aim to alleviate symptoms and slow disease progression. Pharmacological interventions such as acetylcholinesterase inhibitors (e.g., donepezil, rivastigmine) and N-Methyl-D-Aspartate (NMDA) receptor antagonists (e.g., memantine) may provide modest benefits in cognition and function.

In addition to pharmacotherapy, non-pharmacological interventions play a crucial role in managing AD-related symptoms. These may include cognitive stimulation programs, physical exercise, dietary modifications and behavioral therapies customized to the individual's needs.

Caregiver

Caring for a loved one with Alzheimer's disease can be emotionally and physically demanding, often leading to caregiver burden and burnout. Family members may experience stress, depression, social isolation and financial strain as they navigate the challenges of caregiving.

Background and aims

The current state of advance directives in the United States allows only limited options to people facing a diagnosis of Alzheimer’s disease. Existing options focus on choices involving the final stages of Alzheimer’s, e.g., refusing feeding tubes when one can no longer swallow. The question was whether these choices responded to the concerns of many Americans. The hypothesis was that a substantial number might wish their lives to end at earlier stages.

Experimental practice

The effect of central Angiotensin-Converting Enzyme (ACE) inhibition leads to reduced activation of Additional Tier-1 (AT1) receptor in fact the neuroprotective effects of centrally acting AT1 receptor antagonists appear to be even stronger. A recent study determined the treatment effect of centrally acting ACE inhibitors as add-on therapy to an acetylcholinesterase inhibitor in AD patients. Outcome data of the study show that a centrally acting ACE inhibitor could improve AD dementia symptoms for about 9 months after diagnosis of AD, compared to the treatment with a non-centrally acting ACE inhibitor which led to a deterioration of cognitive function. This is a remarkable success considering that the last drug approval for AD i.e., memantine was about 15 years ago. Although ACE inhibitors do not cure AD, the significant improvement of symptoms of dementia with these within 9 months is a much better outcome compared to the one with amyloid beta-targeting approaches in phase III, which did not find any measurable effect on AD symptoms. A recent overview of all clinical trials of amyloid-beta-targeting therapies for Alzheimer disease supports the conclusion. Even if there are still amyloid beta-targeting drug candidates with apparently potential results in early stages of clinical development the failure of all amyloid-beta-targeting compounds in large clinical trials during the past 20 years does not leave much room for expectations to achieve substantial clinical benefit with the amyloid-beta-targeting approach in the future.

Alzheimer's disease poses significant challenges for patients, caregivers and healthcare providers alike. Early recognition of symptoms, accurate diagnosis and multidisciplinary management are essential for optimizing patient outcomes and enhancing quality of life. As study continues to advance new insights into the pathophysiology of AD may prepare for innovative therapeutic strategies and personalized approaches to care. In the meantime raising awareness, providing support services and advocating for policy changes are crucial steps in addressing the growing impact of dementia on individuals and society as a whole. Several clinical data already have shown that inhibition of Angiotensin Converting Enzyme (ACE) retards the process of neurodegeneration leading to dementia and the incidence of AD. Data from clinical practice confirm that the neuroprotective activity is linked to centrally acting ACE inhibitors.