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The Alzheimer ConundrumEntanglements of Dementia and Aging$
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Margaret Lock

Print publication date: 2013

Print ISBN-13: 9780691149783

Published to Princeton Scholarship Online: October 2017

DOI: 10.23943/princeton/9780691149783.001.0001

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Striving to Standardize Alzheimer Disease

Striving to Standardize Alzheimer Disease

(p.51) Chapter 2 Striving to Standardize Alzheimer Disease
The Alzheimer Conundrum

Margaret Lock

Princeton University Press

This chapter considers repeated attempts at diagnostic refinement and standardization of Alzheimer disease (AD). It explores the difficulties of reconciling repeated mismatches between a clinical and a neuropathological diagnosis of AD, as are the discrepancies in diagnoses between specialized memory clinics and general and family practice settings. A diagnosis of AD involves the demonstration at autopsy of neuritic amyloid plaques, neurofibrillary tangles, and also cell loss or shrinkage of brain tissue. For two decades the preeminent model to account for plaque buildup has been the “amyloid cascade hypothesis” that, it is argued, initiates the eventual formation of tangles and other neuropathological changes. The model is currently being questioned by an increasing number of key researchers and continues to be a driving force, even as the entire Alzheimer enterprise moves to include prevention as a major goal.

Keywords:   Alzheimer disease, diagnosis, memory clinics, family practice settings, neuritic amyloid plaques, neurofibrillary tangles, amyloid cascade hypothesis, Alzheimer enterprise

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