Differential diagnosis features of rapidly progressive Alzheimer’s disease

Introduction. The range of pathologies and conditions that can lead to the development of rapidly progressive dementia (RPD) is rather extensive. Alzheimer’s disease (AD) is considered the most common cause of dementia. However, there are other pathologies that, unlike AD, are curable, and, given accurate diagnosis, allow a complete regression of pathological symptoms to be achieved. This highlights the importance of differential diagnosis of rapidly progressing AD from other causes of RPD.

Objective. To determine the differential features of rapidly progressing AD and to study the main causes predisposing to the development of RPD but not related to neurodegenerative pathology.

Discussion. Rapidly progressing AD differs from typical AD in the rate of cognitive decline. On average, rapidly progressing AD is associated with a loss of three points or more scores on the Mini-Mental State Examination (MMSE) test within six months and a faster (in 2–3 years) achievement of the terminal stage of the disease. In case of typical AD, this period is longer, lasting for about 8–10 years. Other major causes of RPD include prion diseases, neurodegenerative diseases of non-prion etiology (including rapidly progressing AD), vascular diseases, infectious diseases, inflammatory and autoimmune diseases, oncological diseases, metabolic and deficiency disorders, endocrine disorders, toxic and iatrogenic disorders, mental diseases, and cerebrovascular pathology.

Conclusions. Identification of the RPD cause requires a detailed and comprehensive examination of the patient using various laboratory and instrumental research methods, which is the key to accurate diagnosis and further successful drug correction of terminal diseases. Positron emission tomography of the brain and such biomarkers as beta-amyloid and hyperphosphorylated tau protein in the cerebrospinal fluid play a major role in the diagnosis of rapidly progressive AD and differential diagnosis from other RPD causes.

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