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Role of Psychiatrists in the Diagnosis and Management of Alzheimer's Disease “Revisited”: A Review and Clinical Opinion

[ Vol. 13 , Issue. 3 ]

Author(s):

Ahmed El-Shafei*, Tarek Asaad, Tarek Darwish, Mohamad Hussain Habil, Ronnachai Kongsakon, Chia-Yih Liu, Joel Raskin, Gerardo Carmelo Salazar, Shenxun Shi, Gang Wang, Liwei Wang, Yen Kuang Yang, Ju-Fen Yeh and Hector Jose Duenas Tentori   Pages 224 - 241 ( 18 )

Abstract:


The number of people diagnosed with Alzheimer's disease (AD) is expected to increase substantially in the near future. In the recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the terminology related to AD has shifted from “dementia” to major or mild “neurocognitive disorder”, emphasizing the cognitive impairment that occurs relatively early in the disease process. The concept of “mild neurocognitive disorder” or “mild cognitive impairment” promotes early detection and diagnosis of AD, particularly by psychiatrists, who often consult the DSM-5. This narrative review describes the current and future role of psychiatrists in the diagnosis and management of AD, focusing on the DSM-5 criteria for mild and major neurocognitive disorder. We summarize some of the key instruments used to assess cognition and the neuropsychiatric and behavioral symptoms that often accompany early AD, neuroimaging diagnostic tools, and newly available AD-specific biomarkers that enhance the ability of clinicians to diagnose early AD. We also briefly describe current and emerging pharmacological treatments for AD that target amyloid and tau and that may modify disease progression. Finally, we provide our clinical opinion on the future role of psychiatrists in AD, the education and training necessary to fulfil this role, interactions between psychiatrists and other specialists as part of a multidisciplinary team, and the potential for routine screening of cognitive function among elderly people.

Keywords:

Alzheimer disease, biomarkers, dementia, early diagnosis, mild cognitive impairment, neurocognitive disorders, psychiatry.

Affiliation:

Eli Lilly (Suisse) S.A., Dubai Healthcare City, PO Box 25319, Dubai, Neuropsychiatric Department, Ain Shams University, Cairo, Behavioural Sciences Pavilion, Sheikh Khalifa Medical City, Abu Dhabi, Department of Psychiatry, MAHSA University, Kuala Lumpur, Department of Psychiatry, Ramathibodi Hospital, Mahidol University, Bangkok, Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Tao-Yuan, Eli Lilly and Company, Indianapolis, IN, Department of Neuroscience, Lucena United Doctors Hospital and Medical Center, Lucena, Department of Psychiatry, Huashan Hospital affiliated to Fudan University, Shanghai, Beijing Anding Hospital, Capital Medical University, Beijing, Department of Psychiatry, Huashan Hospital affiliated to Fudan University, Shanghai, Department of Psychiatry, National Cheng Kung University, Tainan, Eli Lilly and Company (Taiwan, Hong Kong and Macau), Taipei, Eli Lilly y Compania de Mexico, Mexico City



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