[Alzheimer's disease. Review of the current status of research]

The enormous social problems and costs caused by patients suffering from dementia induce growing public interest and become a great challenge of medical science. This report attempts to give a review of recent investigations in neuropathology, genetics, neurotransmitter research, epidemiology, diagnostics and therapy of Alzheimer's dementia, the most common type of dementia. A lot of recent molecular genetic experiments and many neuropathological analogies of Alzheimer's dementia and Down's syndrome indicate a damage on the chromosome 21 as possible cause of Alzheimer's dementia. The neuropathological changes are not limited to the grey matter and cholinergic system, but the white matter and some neurotransmitter systems (noradrenaline, dopamine, serotonin and somatostatin) are affected too. Therapeutical trials to compensate these transmitter deficits show no or only poor clinical benefit. Metabolic studies show disturbances in glucose metabolism of Alzheimer brains suggesting an intraneural energy deficit may be the main damage in Alzheimer's dementia. In spite of extensive technical and psychopathometrical diagnostical attempts Alzheimer's dementia remains to be difficult to diagnose precisely clinically. Best information is given by PET.