Massively increased ventricles, white and gray matter atrophy. Neurofibrillary tangles consisting of hyperphosphoralated material from microtubule assembly are seen histopathologically. Beta amyloid accumulates extracellularly - seen in other pathologies as well. Clinical presentation of Alzheimer's - cognitive, functional, behavioral. MRI if indicated.
Neuropsychologic evaluation can be very useful in helping to make the diagnosis.
Alcohol and drug abuse are frequently uncovered in the assessment of a patient presenting with dementia. This also was seen in functional and behavioral measures. Research has shown that the rate of deterioration is reduced over a two year measure as well. This leads to conclusions that the drugs may have disease modifying effects. Drugs with behavioral modifying effects are also being developed.