INTRODUCTION

The global prevalence of dementia is over 24 million.1 This number is expected to reach over 81 million by the year 2040.1 The most common type of dementia is Alzheimer’s disease (AD) In the United States, it is estimated that more than 5.4 million people are living with AD, with approximately 5.2 million over the age of 65.2,3 Approximately 10.5% of 65-year-olds will develop AD dementia at some point in their life.4 There is evidence that after reaching the age of 65, the incidence of AD doubles every 5 years.5 The prevalence of AD is expected to increase rapidly as the “baby boomer generation” enters old age.2 The financial burden of caring for 5.2 million people with AD is $214 billion.6 This number will rise to$1.2 trillion by 2050 if the projected tripling to 16 million cases occurs.7 Importantly, these estimates are likely conservative, given the numerous causes of dementia. All of these factors underscore the critical importance of developing effective treatments.

Dementia is relentless and devastating. A host of cognitive capacities, as well as the ability to perform activities of daily living (e.g., washing, eating, dressing), are affected. Watching a loved one struggle with dementia can take an incredible emotional toll on family members and caretakers.8 According to the Alzheimer’s Association, in the United States alone 14.9 million family members and caretakers put forth approximately 17 billion hours of unpaid care every year.9 Due to the physically demanding and time-consuming nature of providing care, it is not uncommon for family members to experience depression and loneliness.10,11

The purpose of this chapter is to provide a brief overview of age-related neurocognitive disorders with a particular focus on AD. We also forecast how future advances in technology may enable earlier detection for potentially more effective intervention strategies, as well as promote disease prevention and preservation of brain health.

DEMENTIA

Introduction

Dementia is a broad diagnostic category characterized by a change in cognitive and behavioral functioning. The presentation of dementia is heterogeneous, and involves impairment in multiple domains of functioning, including memory, executive function, attention, visuospatial ability, and language.12 Dementia is typically associated with a change in personality (e.g., difficulty controlling emotions, loss of interest in hobbies), impairment or an inability to perform activities of daily living (e.g., cooking, paying bills), and difficulty in social situations (e.g., maintaining or following conversation, social inappropriateness). Dementia diagnosis is made when the cognitive and behavioral symptoms cause significant interference with activities of daily living or occupation.12 Diagnosis is dependent on self-report accuracy by the patient and/or informant (e.g., family member), the availability of medical or personal records documenting the symptoms over time, the correct administration and interpretation of neurocognitive tests, and the judgment of the clinician.12 In making the diagnosis, it is ...

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