Faculty Bibliography

The development of FAST is of great importance to clinicians in identifying possibly remediable complications of Alzheimer's disease and distinguishing them from the characteristic progression of the illness. Premature loss of speech in an otherwise uncomplicated Alzheimer's-type presentation should lead the clinician to strongly suspect focal cerebral pathology, especially cerebral infarction

Clinical conceptualizations with respect to cognition and dementia in late life have evolved rapidly in recent years. In contrast, many of the compounds that are currently widely prescribed for the amelioration of these conditions were introduced prior to the development of these concepts. Consequently, a reexamination of present and future criteria for drug trials, in accordance with current nosologic and clinical conceptualizations, is necessary at this time and is presented herein. This update will consist of four parts: (1) a brief historical examination of the evolution of current concepts, (2) a brief overview of the current diagnostic criteria that should be utilized in the identification of subjects for pharmacologic trials, (3) a brief overview of efficacy criteria, and (4) a brief overview of the status of pharmacologic investigations that have fulfilled the presently recommended standards

The relationship between alterations in brain structure and brain function was studied in vivo in both young and elderly human subjects. Computed tomography revealed significant age-related ventricular and cortical sulcal dilatation. The cortical changes were most closely related to age. Positron emission tomography failed to show regional changes in brain glucose metabolic rate. The results suggest that the normal aging brain undergoes structural atrophic changes without incurring regional metabolic changes. Examination of the correlations between the structural and the metabolic measures revealed no significant relationships. These data are discussed with respect to the significant structure-function relationships that have been reported in Alzheimer disease.