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Life sciences · Journal article
Focus the Journal of Lifelong Learning in Psychiatry · October 1, 2026
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Alzheimer’s disease (AD) is a progressive neurodegenerative disorder defined pathologically by extracellular β-amyloid plaques and intracellular hyperphosphorylated tau neurofibrillary tangles. Clinically, it is defined by gradual cognitive and functional decline. Over the past decade, AD has evolved from a syndromic clinical-pathologic construct to a biologically defined entity supported by validated cerebrospinal fluid, plasma, and positron emission tomography biomarkers. This shift has generated debate regarding diagnostic thresholds and treatment strategies for individuals who are biomarker positive yet cognitively unimpaired. AD accounts for 60%–70% of dementia cases across the globe, and its prevalence is projected to triple by 2050. Demographic shifts, racial and ethnic disparities, and modifiable vascular and social risk factors underscore the need for equitable, culturally informed care. Amyloid accumulation is thought to precede tau-mediated neurodegeneration by years, with downstream contributions from neuroinflammation, synaptic dysfunction, vascular injury, and metabolic disturbances. Clinically, AD spans a continuum from preclinical stages and mild behavioral impairment to mild cognitive impairment and dementia. Neuropsychiatric symptoms, including apathy, depression, and psychosis, are common and increase caregiver burden and institutionalization risk. Psychiatry is uniquely positioned to identify and manage AD in collaboration with other disciplines. Diagnostic evaluation integrates clinical assessment, cognitive testing, functional measures, structural neuroimaging, and increasingly fluid and plasma biomarkers. Treatment includes symptomatic therapies (cholinesterase inhibitors, memantine), recently approved anti-amyloid monoclonal antibodies for early symptomatic disease, and management of neuropsychiatric symptoms and vascular risk factors. Multidisciplinary, caregiver-centered care remains foundational as emerging precision medicine approaches reshape AD diagnosis and management.