Aging Clinical and Experimental Research

, Volume 13, Issue 3, pp 171–182 | Cite as

Natural history of Alzheimer’s disease

  • L. S. Honig
  • R. Mayeux
Review Article


Alzheimer’s disease (AD) is the principal cause of dementia in the elderly, and affects about 15 million people worldwide. The earliest symptom is usually an insidious impairment of memory. As the disease progresses, there is increasing impairment of language and other cognitive functions. Problems occur with naming and word-finding, and later with verbal and written comprehension and expression. Visuospatial, analytic and abstract reasoning abilities, judgment, and insight become affected. Behavioral changes may include delusions, hallucinations, irritability, agitation, verbal or physical aggression, wandering, and disinhibition. Ultimately, there is loss of self-hygiene, eating, dressing, and ambulatory abilities, and incontinence and motor dysfunction. Before diagnosis of AD, individuals may have memory complaints, which represent a period of mild cognitive impairment (MCI). Before MCI, there is a prodromal, illdefined presymptomatic period of disease (“pre- MCI”). In this review, we particularly focus on these earliest stages. We also discuss the more advanced stages of AD, and address factors that may influence disease course. Understanding the natural history of AD will allow better targeting of the disease-modifying treatments that are on the horizon.

Key words

Aging Alzheimer’s disease (AD) mild cognitive impairment (MCI) natural history of AD pre-symptomatic AD (pre-MCI) 


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Copyright information

© Springer Internal Publishing Switzerland 2001

Authors and Affiliations

  1. 1.Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Gertrude H. Sergievsky Center, and Department of NeurologyColumbia University College of Physicians and SurgeonsNew YorkUSA

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