Mécanismes, facteurs de risque et stratégies thérapeutiques dans la maladie d'Alzheimer

Alzheimer's disease can have an early (30-55 years of age) or a late onset (sporadic; > 65 years of age) with a long preclinical and prodromal phase (≥ 20 years). Both forms of the disease are related to an accumulation of toxic β-amyloid peptides in the extracellular spaces of the brain, resulting from abnormal processing of the amyloid precursor protein (APP). The sporadic form has an estimated prevalence of 10-30% after age 65 and seems to be related to numerous environmental factors. The early form of the disease is the consequence of inherited mutations in genes that affect the processing of APP and/or the clearance of β-amyloid peptides. During the incubation period, it is possible to identify the disease by biochemical analysis of the cerebrospinal fluid (CSF biomarkers) or by neuro-imaging of the brain (PET scan). Numerous symptomatic drugs can be used to ameliorate the disease; however, curative treatments are still under investigation. Management is focused on the support of the social networks surrounding the patient and the treatment of possible co-morbid illnesses.