Title:Role of Psychiatrists in the Diagnosis and Management of Alzheimer's Disease “Revisited”: A Review and Clinical Opinion
Volume: 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
Affiliation:
- Eli Lilly (Suisse) S.A., Dubai Healthcare City, PO Box 25319, Dubai,United Arab Emirates
Keywords:
Alzheimer disease, biomarkers, dementia, early diagnosis, mild cognitive impairment, neurocognitive disorders,
psychiatry.
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.