Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Dementia of the Alzheimer type: current state of the problem

Full Text:


The current knowledge on epidemiology, diagnosis, and treatment of Alzheimer's disease and dementia of the Alzheimer type are presented.

Various approaches to therapy based on current understanding of the pathogenesis of the degenerative process are discussed with allowance for the clinical features of the disease (psychopathologic symptoms and stage of the disease). Special attention is paid to compensatory therapy aimed at compensating for the deficit in cholinergic and glutamatergic neurotransmission. 

About the Authors

N.A. Tyuvina
Department of Psychiatry and Addiction Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
Russian Federation

V.V. Balabanova
Department of Psychiatry and Addiction Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Moscow, Russia
Russian Federation


1. Alzheimer A. Жber eine eigenartige Erkrankung der Hirnrinde [About a peculiar disease of the cerebral cortex]. Allgemeine Zeitschrift fur Psychiatrie und Psychisch-Gerichtlich Medizin. 1907;64(1–2):146–8.

2. Kraepelin E. Psychiatrie. Ein Lehrbuch fü r Studierende und Ärzte. Achte, vollstКndig umgearbeitete Auflage. II. Band. Klinische Psychiatrie. I Teil. Leipzig: Barth Verlag; 1909.

3. Alzheimer A. Über eigenartige Krankheits fä lle des spä teren Alters. Z Gesamte Neurol Psychiat. 1911;(4) :356–85.

4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington: DC, American Psychiatric Association; 1994.

5. World Health Organization: International Classification of Diseases, 8th Revision. Geneva: World Health Organization; 1967.

6. World Health Organization: International Statistical Classification of Diseases and Related Health Problems, 10th Revision. Geneva: World Health Organization; 1992.

7. Гаврилова СИ, Калын ЯБ, Герасимов НП и др. Новая форма специализированной помощи пожилым больным с деменцией (организационные и фармако-экономические аспекты). Социальная и клиническая психиатрия. 2008;18(2):36–40. [Gavrilova SI, Kalyn YaB, Gherasimov NP, et al. A new form of specialized care for elderly people with dementia (organizational and pharmacoeconomic issues). Sotsial'naya i klinicheskaya psikhiatriya. 2008;18(2):36–40. (In Russ.)]

8. Rocca WA, Hofman A, Brayne C, et al. Frequency and distribution of Alzheimer's disease in Europe: a collaborative study of 1980–1990 prevalence findings.

9. The EURODEM-Prevalence Research Group. Ann Neurol. 1991;30(3):381–90. DOI:

10. Von Strauss E, Viitanen M, De Ronchi D, et al. Aging and the occurrence of dementia: findings from a population-based cohort with a large sample of nonagenarians. Arch Neurol. 1999;56(5):587–92. DOI:

11. Hebert LE, Scherr PA, Beckett LA, et al. Age specific incidence of Alzheimer’s disease in a community population. JAMA. 1995;273(17):1354–9. DOI: 1995.03520410048025.

12. Jellinger KA, Attems J. Neuropathological evaluation of mixed dementia. Review. J Neurol Sci. 2007;257(1–2):80–7. DOI: Epub 2007 Feb 26.

13. Штернберг ЭЯ. Клиника деменций пресенильного возраста. Москва: Медицина; 1967. 247 с. [Shternberg EYa. Klinika dementsii presenil'nogo vozrasta [Clinic of dementias of presenilny age]. Moscow: Meditsina; 1967. 247 p.]

14. Wang GD, Lai DJ, Burau KD, Du XL. Potential gains in life expectancy from reducing heart disease, cancer, Alzheimer’ disease or HIV/AIDS a major causes of death in the USA. Public Health. 2013;127(4):348–56. DOI: 14. Парфенов ВА. Профилактика болезни Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2011;(3):8–13. [Parfenov VA. Prevention of Alzheimer's disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;(3):8–13. (In Russ.)]. DOI: 14412/2074-2711-2011-159.

15. Kalaria RN, Akinyemi R, Ihara M. Does vascular pathology contribute to Alzheimer changes? J Neurol Sci. 2012;322(1–2):141–7.

16. Li G, Rhew IC, Shofer JB, et al. Age-varying association between blood pressure and risk of dementia in those aged 65 and older: a community-based prospective cohort study. J Am Geriatr Soc. 2007;55(8):1161–7. DOI:

17. Biessels GJ, Staekenborg S, Brunner E, et al. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol. 2006;5(1):64–74. DOI:

18. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev. 2011;12(5):e426–37. DOI: 10.1111/j.1467-789X.2010.00825.x. Epub 2011 Feb 23.

19. Ho L, Zhao W, Dams-O'Connor K, et al. Elevated plasma MCP-1 concentration following traumatic brain injury as a potential «predisposition» factor associated with an increased risk for subsequent development of Alzheimer's disease. J Alzheimers Dis. 2012;31(2):301–13.

20. Tan ZS, Vasan RS. Thyroid function and Alzheimer's disease. J Alzheimers Dis. 2009;16(3):503–7.

21. Wu KY, Hsiao IT, Chen CS, et al. Increased brain amyloid deposition in patients with a lifetime history of major depression: evidence on positron emission tomography. Eur J Nucl Med Mol Imaging. 2013 Nov 15. [Epub ahead of print]. DOI:

22. Ptok U, Papassotiropoulos A, Maier W, Heun R. Advanced parental age: a risk factor for Alzheimer's disease or depression in the elderly? Int Psychogeriatr. 2000;12(4):445–51. DOI:

23. Pardon MC, Rattray I. What do we know about the long-term consequences of stress on ageing and the progression of age-related neurodegenerative disorders? Neurosci Biobehav Rev. 2008;32(6):1103–20. DOI:

24. Vest RS, Pike CJ. Gender, sex steroid hormones, and Alzheimer's disease. Horm Behav. 2013;63(2):301–7. DOI: 10.1016/j.yhbeh.2012.04.006. Epub 2012 Apr 19.

25. Enciu AM, Popescu BO. Is there a causal link between inflammation and dementia? Biomed Res Int. 2013;2013:316495. DOI: 10.1155/2013/316495. Epub 2013 Jun 6. Review.

26. Barberger-Gateau P, Letenneur L, Deschamps V, et al. Fish, meat, and risk of dementia: cohort study. BMJ. 2002;325(7370):932–3. DOI:

27. Letenneur L. Risk of dementia and alcohol and wine consumption: a review of recent results. Biol Res. 2004;37(2):189–93. DOI:

28. Almeida OP, Hulse GK, Lawrence D, Flicker L. Smoking as a risk factor for Alzheimer’s disease: contrasting evidence from a systematic review of case-control and cohort studies. Addiction. 2002;97(1):15–28. DOI:

29. Гаврилова СИ. Болезнь Альцгеймера: современные представления о диагностике и терапии. Русcкий медицинский журнал. 1997;5(20):1339–47. [Gavrilova SI. Alzheimer's disease: modern ideas of diagnostics and therapy. Rusckii meditsinskii zhurnal. 1997;5(20):1339–47. (In Russ.)]

30. Жислин СГ. Очерки клинической психиатрии. Москва: Медицина; 1965. 320 с. [Zhislin SG. Ocherki klinicheskoi psikhiatrii [Sketches of clinical psychiatry]. Moscow: Meditsina; 1965. 320 p.]

31. Scarmeas N, Albert M, Brandt J, et al. Motor signs predict poor outcomes in Alzheimer disease. Neurology. 2005;64(10):1696–703. DOI: WNL.0000162054.15428.E9.

32. Plassman BL, Breitner JC. Recent advances in the genetics of Alzheimer's disease and vascular dementia with an emphasis on gene-environment interactions. J Am Geriatr Soc. 1996;44(10):1242–50.

33. Sleegers K, Van Duijn CM. Alzheimer's disease: genes, pathogenesis and risk prediction. Community Genet. 2001;4(4):197–203. DOI:

34. Wragg M, Hutton M, Talbot C. The Alzheimer's Disease Collaborative Group. Genetic association between intronic polymorphism in presenilin-1 gene and late-onset Alzheimer's disease. Lancet. 1996;347(9000):509–12. DOI:

35. Scheuner D, Eckman C, Jensen M, et al. Secreted amyloid І-protein similar to that in the senile plaques of Alzheimer's disease is increased in vivo by the presenilin 1 and 2 and APP mutations linked to familial Alzheimer's disease. Nat Med. 1996;2(8):864–70. DOI:

36. Kwok JB, Taddei K, Hallupp M, et al. Two novel (M233Tand R278T) presenilin-1 mutations in early-onset Alzheimer's disease pedigrees and preliminary evidence for association of presenilin-1 mutations with a novel phenotype. Neuroreport. 1997;8(6):1537–42. DOI:

37. Sato S, Kamino K, Miki T, et al. Splicing mutation of presenilin-1 gene for early-onset familial Alzheimer's disease. Hum Mutat. 1998;Suppl 1:S91–S94. DOI: 38. Schilling S, DeStefano AL, Sachdev PS, et al. APOE genotype and MRI markers of cerebrovascular disease: systematic review and meta-analysis. Neurology. 2013;81(3):292–300. DOI: WNL.0b013e31829bfda4.

38. Lambert JC, Araria-Goumidi L, Myllykangas L, et al. Contribution of APOE promoter polymorphisms to Alzheimer's disease risk. Neurology. 2002;59(1):59–66. DOI:

39. Strittmatter WJ, Saunders AM, Schmechel D, et al. Apolipoprotein E: highavidity binding to І-amyloid and increased frequency of type 4 allele in lateonset familial Alzheimer disease. Proc Natl Acad Sci U S A. 1993;90(5):1977–81. DOI:

40. Nathan BP, Chang KC, Bellosta S, et al. The inhibitory effect of apolipoprotein E4 on neurite outgrowth is associated with microtubule depolymerization. J Biol Chern. 1995;270(34):19791–9. DOI:

41. Jellinger KA. Challenges in neuronal apoptosis. Curr Alzheimer Res. 2006;3(4):377–91. DOI: 156720506778249434.

42. Davies P, Maloney AJ. Selective loss of central cholinergic neurons in Alzheimer’s disease (letter). Lancet. 1976;2(8000):1403. DOI:

43. Drachman DA, Leavitt J. Human memory and the cholinergic system. Arch Neurol. 1974;30(2):113–21. DOI:

44. Ещенко НД. Биохимия психических и нервных болезней. Cанкт-Петербургг: СПБГУ; 2004. 204 с. [Eshchenko ND. Biokhimiya psikhicheskikh i nervnykh boleznei [Biochemistry of mental and nervous diseases]. St-Petersburg: SPBGU; 2004. 204 p.]

45. Weiner MF, Lipton AM, editor. The American Psychiatric Publishing textbook of Alzheimer disease and other dementias. 1st ed. American Psychiatric Publishing Inc; 2009. P. 317–24.

46. Преображенская ИС. Диагностика и лечение болезни Альцгеймера. Спецвыпуск: Когнитивные и другие нервно-прихические расстройства. Неврология, нейропсихитрия, психосоматика. 2012;(2S):5–10. [Preobrazhenskaya IS. Alzheimer's disease: diagnosis and treatment. Special issue: Сognitive and other neuropsychiatric disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2S):5–10. (In Russ.)]. DOI:

47. Noetzli M, Eap CB. Pharmacodynamic, pharmacokinetic and pharmacogenetic aspects of drugs used in the treatment of Alzheimer's disease. Clin Pharmacokinet. 2013;52(4):225–41. DOI: 10.1007/s40262-013-0038-9.

48. Гаврилова СИ, Герасимов НП, Калын ЯБ и др. Долговременные эффекты глутаматергической терапии болезни Альцгеймера на стадии умеренно-тяжелой и тяжелой деменции (Результаты 26-недельного сравнительного клинического исследования в параллельных группах больных: леченных акатинолом мемантином и получавших симптоматическую нейролептическую терапию). Социальная и клиническая психиат- рия. 2006;16(1):32–7. [Gavrilova SI, Gerasimov NP, Kalyn YaB, et al. Long-term effects of the glutamate therapy in moderate and severe alzheimer disease: results of a 26- week comparative trial of akatinol-memantine vs. symptomatic neuroleptic medication. Sotsial'naya i klinicheskaya psikhiatriya. 2006;16(1):32–7. (In Russ.)]

49. Grossberg GT, Manes F, Allegri RF, et al. The safety, tolerability, and efficacy of once-daily memantine (28 mg): a multinational, randomized, double-blind, placebo-con- trolled trial in patients with moderate-to-severe Alzheimer's disease taking cholinesterase inhibitors. CNS Drugs. 2013;27(6):469–78. DOI: 0077-7.

50. Вознесенская ТГ. Акатинол в лечении некогнитивных нервно-психических расстройств при нейрогериатрических заболеваниях. Спецвыпуск: Когнитивные и другие нервно-пcихические расстройства. Неврология, нейропсихиатрия, психосоматика. 2012;(2S):11–7. [Voznesenskaya TG. Akatinol in the treatment of noncognitive neuropsychological disorders in neurogeriatric diseases. Special issue: Сognitive and other neuropsychiatric disorders. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(2S):11–7.]. DOI:

51. Reisberg B, Doody R, StЪffler A, et al. Memantine Study Group. Memantine in moderate-to-severe Alzheimer's disease. N Engl J Med. 2003;348(14):1333–41. DOI:

52. Вознесенская ТГ, Медведева АВ, Яхно НН. Некогнитивные нейропсихические расстройства при БА и их коррекция. Неврологический журнал. 2010;15(4):18–24. [Voznesenskaya TG, Medvedeva AV,

53. Yakhno NN. Not cognitive neuromental disorders at OH and their correction. Nevrologicheskii zhurnal. 2010;15(4):18–24. (In Russ.)]

54. Maidment ID, Fox CG, Boustani M, et al. Efficacy of memantine on behavioural and psychological symptoms related to dementia – a systematic meta-analyses. Ann Pharmacother. 2008;42(1):32–8. DOI:

55. Gauthier S, Loft H, Cummings J. Improvement in behavioural symptoms in patients with moderate to severe AD by memantine: a pooled data analysis. Int J Geriatr Psychiatry. 2008;23(5):537–45. DOI:

56. Wilcock GK, Ballard CG, Cooper JA, et al. Memantine for agitation/aggression and psychosis in moderate severe AD: a pooled analisis of 3 studies. J Clin Psychiatry. 2008;69(3):341–8. DOI:

57. Lopez OL, Becker JT, Wahed AS, et al. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatr. 2009;80(6):600–7. DOI: 58. Chow TW, Pollock BG, Milgram NW. Potential cognitive enhancing and disease modification effects of SSRIs for Alzheimer’s disease. Neuropsychiatr Dis Treat. 2007;3(5):627–36.


For citations:

Tyuvina N., Balabanova V. Dementia of the Alzheimer type: current state of the problem. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(1):61-67. (In Russ.)

Views: 1149

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)