Issue

Vol. 2 No. 2 (2025)

Date Log

Submitted
August 31, 2026
Published
December 31, 2025

Copyright (c) 2025 Yahya Mohammed Jordy Qaisi, Saud Ahmed Ali Kabani, Mansour Ahmed Slman Amri, Asma Fareed Alshammari, Moneerah Shaman Fahid Aljuhani, Hissah Sunytan Nasser Almutairi, Obaid Mubarak Alluwaymi, Reham Fahad Ahmad Mani, Heba Abdo Mohammed Khardly, Asrar Ayed Almutairi, Mohammad Mitran Zailaie

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Alzheimer Disease: An Integrated Multidisciplinary Perspective on Pathophysiology, Diagnosis, Management, and Contemporary Therapeutic Advances for Pharmacists, Neurologists, Nurses, Health Information Professionals, and Healthcare Assistants

https://doi.org/10.64483/202522763
Yahya Mohammed Jordy Qaisi
Samtah General Hospital,Ministry of Health, Saudi Arabia
Saud Ahmed Ali Kabani
Damad General Hospital,Ministry of Health , Saudi Arabia
Mansour Ahmed Slman Amri
Primary Health Care, Jazan,Ministry of Health , Saudi Arabia
Asma Fareed Alshammari
Hafar Al-Batin Health Cluster, Maternity and Children Hospital,Ministry of Health , Saudi Arabia
Moneerah Shaman Fahid Aljuhani
Hafar Al-Batin Health Cluster, Maternity and Children Hospital,Ministry of Health , Saudi Arabia
Hissah Sunytan Nasser Almutairi
Maternity and Children's Hospital, Hafar Al-Batin, Ministry of Health, Saudi Arabia
Obaid Mubarak Alluwaymi
Al-Mansoura Health Center, Riyadh, First Health Cluster, Ministry of Health, Saudi Arabia
Reham Fahad Ahmad Mani
King Fahd Central Hospital, Jazan, Ministry of Health, Saudi Arabia
Heba Abdo Mohammed Khardly
King Fahd Central Hospital, Jazan, Ministry of Health, Saudi Arabia
Asrar Ayed Almutairi
Maternity and Children's Hospital, Hafar Al-Batin, Ministry of Health, Saudi Arabia
Mohammad Mitran Zailaie
PMBNH, Ministry of Health, Saudi Arabia

Corresponding Author(s) : Yahya Mohammed Jordy Qaisi

sice9102@hutdot.com

Saudi Journal of Medicine and Public Health, Vol. 2 No. 2 (2025)

Abstract

Background: Alzheimer disease is a progressive neurodegenerative disorder characterized by cognitive decline, neuronal loss, amyloid-beta accumulation, neurofibrillary tau pathology, and progressive functional deterioration. Its increasing prevalence among older adults represents a growing global health burden. Advances in understanding the molecular, cellular, genetic, and pathological mechanisms of Alzheimer disease have improved approaches to diagnosis, biomarker development, and therapeutic intervention.


Aim: This article aims to provide an integrated academic overview of Alzheimer disease, focusing on its epidemiology, etiology, pathophysiology, histopathological characteristics, clinical assessment, diagnostic evaluation, and current management approaches.


Methods: A narrative review approach was used to synthesize information concerning the biological mechanisms, clinical manifestations, diagnostic methods, pathological characteristics, and therapeutic strategies associated with Alzheimer disease. The review incorporated clinical, biochemical, genetic, neuroimaging, and neuropathological perspectives to provide a comprehensive description of disease development and management.


Results: Alzheimer disease involves interacting mechanisms that include amyloid-beta accumulation, abnormal tau phosphorylation and aggregation, cholinergic dysfunction, synaptic degeneration, neuronal loss, neuroinflammation, vascular pathology, and genetic susceptibility. Increasing age represents the principal epidemiological risk factor, while APOE ε4, cardiovascular disease, diabetes, obesity, and family history contribute to disease susceptibility. Diagnosis integrates clinical assessment, cognitive testing, laboratory investigations, structural and functional neuroimaging, and selected amyloid and tau biomarkers. Current management includes cholinesterase inhibitors, memantine, behavioral interventions, lifestyle measures, and emerging amyloid-targeting disease-modifying therapies.


Conclusion: Alzheimer disease represents a multifactorial neurodegenerative disorder requiring integrated diagnostic and therapeutic strategies. Earlier identification of pathological changes and continued development of disease-modifying interventions may improve clinical outcomes and reduce disease burden.

Keywords

Alzheimer disease, dementia, amyloid-beta, tau protein, neurodegeneration, cholinergic dysfunction, biomarkers, neuroimaging, cognitive impairment, disease-modifying therapy.
Qaisi, Y. M. J., Saud Ahmed Ali Kabani, Mansour Ahmed Slman Amri, Asma Fareed Alshammari, Moneerah Shaman Fahid Aljuhani, Hissah Sunytan Nasser Almutairi, … Mohammad Mitran Zailaie. (2025). Alzheimer Disease: An Integrated Multidisciplinary Perspective on Pathophysiology, Diagnosis, Management, and Contemporary Therapeutic Advances for Pharmacists, Neurologists, Nurses, Health Information Professionals, and Healthcare Assistants. Saudi Journal of Medicine and Public Health, 2(2), 3806–3818. https://doi.org/10.64483/202522763
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX
References
  1. Ahmad FB, Cisewski JA, Xu J, Anderson RN. Provisional Mortality Data - United States, 2022. MMWR Morb Mortal Wkly Rep. 2023 May 05;72(18):488-49
  2. Mendez MF. Early-Onset Alzheimer Disease. Neurol Clin. 2017 May;35(2):263-281.
  3. Zetterberg H, Bendlin BB. Biomarkers for Alzheimer's disease-preparing for a new era of disease-modifying therapies. Mol Psychiatry. 2021 Jan;26(1):296-308.
  4. Porsteinsson AP, Isaacson RS, Knox S, Sabbagh MN, Rubino I. Diagnosis of Early Alzheimer's Disease: Clinical Practice in 2021. J Prev Alzheimers Dis. 2021;8(3):371-386.
  5. Therriault J, Zimmer ER, Benedet AL, Pascoal TA, Gauthier S, Rosa-Neto P. Staging of Alzheimer's disease: past, present, and future perspectives. Trends Mol Med. 2022 Sep;28(9):726-741.
  6. Tang Y, Lutz MW, Xing Y. A systems-based model of Alzheimer's disease. Alzheimers Dement. 2019 Jan;15(1):168-171.
  7. Zilberzwige-Tal S, Gazit E. Go with the Flow-Microfluidics Approaches for Amyloid Research. Chem Asian J. 2018 Nov 16;13(22):3437-3447.
  8. Maccioni RB, González A, Andrade V, Cortés N, Tapia JP, Guzmán-Martínez L. Alzheimer´s Disease in the Perspective of Neuroimmunology. Open Neurol J. 2018;12:50-56.
  9. Santos CY, Snyder PJ, Wu WC, Zhang M, Echeverria A, Alber J. Pathophysiologic relationship between Alzheimer's disease, cerebrovascular disease, and cardiovascular risk: A review and synthesis. Alzheimers Dement (Amst). 2017;7:69-87.
  10. Anjum I, Fayyaz M, Wajid A, Sohail W, Ali A. Does Obesity Increase the Risk of Dementia: A Literature Review. Cureus. 2018 May 21;10(5):e2660.
  11. Nicolas G, Acuña-Hidalgo R, Keogh MJ, Quenez O, Steehouwer M, Lelieveld S, Rousseau S, Richard AC, Oud MS, Marguet F, Laquerrière A, Morris CM, Attems J, Smith C, Ansorge O, Al Sarraj S, Frebourg T, Campion D, Hannequin D, Wallon D, Gilissen C, Chinnery PF, Veltman JA, Hoischen A. Somatic variants in autosomal dominant genes are a rare cause of sporadic Alzheimer's disease. Alzheimers Dement. 2018 Dec;14(12):1632-1639.
  12. Liljegren M, Landqvist Waldö M, Rydbeck R, Englund E. Police Interactions Among Neuropathologically Confirmed Dementia Patients: Prevalence and Cause. Alzheimer Dis Assoc Disord. 2018 Oct-Dec;32(4):346-350.
  13. Tong BC, Wu AJ, Li M, Cheung KH. Calcium signaling in Alzheimer's disease & therapies. Biochim Biophys Acta Mol Cell Res. 2018 Nov;1865(11 Pt B):1745-1760.
  14. Li X, Feng X, Sun X, Hou N, Han F, Liu Y. Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2019. Front Aging Neurosci. 2022;14:937486.
  15. Qiu C, Kivipelto M, von Strauss E. Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. Dialogues Clin Neurosci. 2009;11(2):111-28.
  16. Breijyeh Z, Karaman R. Comprehensive Review on Alzheimer's Disease: Causes and Treatment. Molecules. 2020 Dec 08;25(24)
  17. Hampel H, Mesulam MM, Cuello AC, Farlow MR, Giacobini E, Grossberg GT, Khachaturian AS, Vergallo A, Cavedo E, Snyder PJ, Khachaturian ZS. The cholinergic system in the pathophysiology and treatment of Alzheimer's disease. Brain. 2018 Jul 01;141(7):1917-1933.
  18. Paroni G, Bisceglia P, Seripa D. Understanding the Amyloid Hypothesis in Alzheimer's Disease. J Alzheimers Dis. 2019;68(2):493-510.
  19. Salehi A, Ashford JW, Mufson EJ. The Link between Alzheimer's Disease and Down Syndrome. A Historical Perspective. Curr Alzheimer Res. 2016;13(1):2-6.
  20. Hoogmartens J, Cacace R, Van Broeckhoven C. Insight into the genetic etiology of Alzheimer's disease: A comprehensive review of the role of rare variants. Alzheimers Dement (Amst). 2021;13(1):e12155.
  21. Serrano-Pozo A, Frosch MP, Masliah E, Hyman BT. Neuropathological alterations in Alzheimer disease. Cold Spring Harb Perspect Med. 2011 Sep;1(1):a006189.
  22. Braak H, Thal DR, Ghebremedhin E, Del Tredici K. Stages of the pathologic process in Alzheimer disease: age categories from 1 to 100 years. J Neuropathol Exp Neurol. 2011 Nov;70(11):960-9.
  23. Bloom GS. Amyloid-β and tau: the trigger and bullet in Alzheimer disease pathogenesis. JAMA Neurol. 2014 Apr;71(4):505-8.
  24. Greenberg SM, Bacskai BJ, Hernandez-Guillamon M, Pruzin J, Sperling R, van Veluw SJ. Cerebral amyloid angiopathy and Alzheimer disease - one peptide, two pathways. Nat Rev Neurol. 2020 Jan;16(1):30-42.
  25. Verma M, Wills Z, Chu CT. Excitatory Dendritic Mitochondrial Calcium Toxicity: Implications for Parkinson's and Other Neurodegenerative Diseases. Front Neurosci. 2018;12:523.
  26. Wallace L, Theou O, Rockwood K, Andrew MK. Relationship between frailty and Alzheimer's disease biomarkers: A scoping review. Alzheimers Dement (Amst). 2018;10:394-401.
  27. Vik-Mo AO, Bencze J, Ballard C, Hortobágyi T, Aarsland D. Advanced cerebral amyloid angiopathy and small vessel disease are associated with psychosis in Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2019 Jun;90(6):728-730.
  28. Santacruz KS, Swagerty D. Early diagnosis of dementia. Am Fam Physician. 2001 Feb 15;63(4):703-13, 717-8.
  29. Jia X, Wang Z, Huang F, Su C, Du W, Jiang H, Wang H, Wang J, Wang F, Su W, Xiao H, Wang Y, Zhang B. A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC Psychiatry. 2021 Oct 04;21(1):485.
  30. Ciesielska N, Sokołowski R, Mazur E, Podhorecka M, Polak-Szabela A, Kędziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol. 2016 Oct 31;50(5):1039-1052.
  31. Limpawattana P, Manjavong M. The Mini-Cog, Clock Drawing Test, and Three-Item Recall Test: Rapid Cognitive Screening Tools with Comparable Performance in Detecting Mild NCD in Older Patients. Geriatrics (Basel). 2021 Sep 16;6(3)
  32. Haapasalo A, Hiltunen M. A report from the 8th Kuopio Alzheimer Symposium. Neurodegener Dis Manag. 2018 Oct;8(5):289-299.
  33. Kim H. Detection of severity in Alzheimer's disease (AD) using computational modeling. Bioinformation. 2018;14(5):259-264.
  34. Petersen RC. How early can we diagnose Alzheimer disease (and is it sufficient)? The 2017 Wartenberg lecture. Neurology. 2018 Aug 28;91(9):395-402.
  35. Sobański M, Zacharzewska-Gondek A, Waliszewska-Prosół M, Sąsiadek MJ, Zimny A, Bladowska J. A Review of Neuroimaging in Rare Neurodegenerative Diseases. Dement Geriatr Cogn Disord. 2020;49(6):544-556.
  36. Bottino CM, Castro CC, Gomes RL, Buchpiguel CA, Marchetti RL, Neto MR. Volumetric MRI measurements can differentiate Alzheimer's disease, mild cognitive impairment, and normal aging. Int Psychogeriatr. 2002 Mar;14(1):59-72.
  37. Frisoni GB, Boccardi M, Barkhof F, Blennow K, Cappa S, Chiotis K, Démonet JF, Garibotto V, Giannakopoulos P, Gietl A, Hansson O, Herholz K, Jack CR, Nobili F, Nordberg A, Snyder HM, Ten Kate M, Varrone A, Albanese E, Becker S, Bossuyt P, Carrillo MC, Cerami C, Dubois B, Gallo V, Giacobini E, Gold G, Hurst S, Lönneborg A, Lovblad KO, Mattsson N, Molinuevo JL, Monsch AU, Mosimann U, Padovani A, Picco A, Porteri C, Ratib O, Saint-Aubert L, Scerri C, Scheltens P, Schott JM, Sonni I, Teipel S, Vineis P, Visser PJ, Yasui Y, Winblad B. Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers. Lancet Neurol. 2017 Aug;16(8):661-676.
  38. Johnson KA, Fox NC, Sperling RA, Klunk WE. Brain imaging in Alzheimer disease. Cold Spring Harb Perspect Med. 2012 Apr;2(4):a006213.
  39. Blennow K, Zetterberg H. Biomarkers for Alzheimer's disease: current status and prospects for the future. J Intern Med. 2018 Dec;284(6):643-663.
  40. Hussein W, Sağlık BN, Levent S, Korkut B, Ilgın S, Özkay Y, Kaplancıklı ZA. Synthesis and Biological Evaluation of New Cholinesterase Inhibitors for Alzheimer's Disease. Molecules. 2018 Aug 14;23(8)
  41. Leblhuber F, Steiner K, Schuetz B, Fuchs D, Gostner JM. Probiotic Supplementation in Patients with Alzheimer's Dementia - An Explorative Intervention Study. Curr Alzheimer Res. 2018;15(12):1106-1113.
  42. Adlimoghaddam A, Neuendorff M, Roy B, Albensi BC. A review of clinical treatment considerations of donepezil in severe Alzheimer's disease. CNS Neurosci Ther. 2018 Oct;24(10):876-888.
  43. Kumar A, Gupta V, Sharma S. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 17, 2023. Donepezil.
  44. Kandiah N, Pai MC, Senanarong V, Looi I, Ampil E, Park KW, Karanam AK, Christopher S. Rivastigmine: the advantages of dual inhibition of acetylcholinesterase and butyrylcholinesterase and its role in subcortical vascular dementia and Parkinson's disease dementia. Clin Interv Aging. 2017;12:697-707.
  45. Kalola UK, Patel P, Nguyen H. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jun 8, 2024. Galantamine.
  46. Khoury R, Grysman N, Gold J, Patel K, Grossberg GT. The role of 5 HT6-receptor antagonists in Alzheimer's disease: an update. Expert Opin Investig Drugs. 2018 Jun;27(6):523-533.
  47. Cummings J, Lee G, Nahed P, Kambar MEZN, Zhong K, Fonseca J, Taghva K. Alzheimer's disease drug development pipeline: 2022. Alzheimers Dement (N Y). 2022;8(1):e12295.
  48. Padda IS, Parmar M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Feb 26, 2024. Aducanumab.
  49. van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M, Li D, Reyderman L, Cohen S, Froelich L, Katayama S, Sabbagh M, Vellas B, Watson D, Dhadda S, Irizarry M, Kramer LD, Iwatsubo T. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2023 Jan 05;388(1):9-21.
  50. Rashad A, Rasool A, Shaheryar M, Sarfraz A, Sarfraz Z, Robles-Velasco K, Cherrez-Ojeda I. Donanemab for Alzheimer's Disease: A Systematic Review of Clinical Trials. Healthcare (Basel). 2022 Dec 22;11(1)
  51. Sperling RA, Jack CR, Black SE, Frosch MP, Greenberg SM, Hyman BT, Scheltens P, Carrillo MC, Thies W, Bednar MM, Black RS, Brashear HR, Grundman M, Siemers ER, Feldman HH, Schindler RJ. Amyloid-related imaging abnormalities in amyloid-modifying therapeutic trials: recommendations from the Alzheimer's Association Research Roundtable Workgroup. Alzheimers Dement. 2011 Jul;7(4):367-85.
Read More
Author biographies is not available.
Download
PDF
Statistic
Read Counter : 5 Download : 25