Alzheimer's disease in aging: Neurobiological and clinical aspects and contemporary challenges for early diagnosis

Authors

DOI:

https://doi.org/10.33448/rsd-v15i5.51085

Keywords:

Alzheimer's Disease, Dementia, Neurology, Early Diagnosis, Mental Health.

Abstract

Alzheimer's Disease (AD) is the leading cause of dementia worldwide, characterized as a progressive, multifactorial neurodegenerative disease of high public health relevance, especially in the context of population aging. This study aimed to analyze, in light of contemporary scientific evidence, the neurobiological, clinical, and psychosocial aspects of Alzheimer's Disease, with an emphasis on the challenges related to early diagnosis. This is a qualitative-quantitative investigation, with an integrative literature review design, based on studies published in international scientific databases, including PubMed/MEDLINE, Scopus, Web of Science, SciELO, and BVS, from 2020 to 2025. The selection process followed the PRISMA 2020 guidelines, resulting in the inclusion of 37 studies, organized into thematic areas related to prevalence, early diagnosis, clinical manifestations, and neurobiological mechanisms of the disease. The results showed that Alzheimer's Disease presents early neuropsychiatric manifestations, such as apathy, anxiety, irritability, depression, and anosognosia, in addition to progressive impairment of multiple cognitive domains, including memory, language, executive functions, and visuospatial skills. Additionally, psychosocial factors, such as social isolation, chronic stress, depression, and anxiety, demonstrated a significant influence on the progression of the disease and the quality of life of affected individuals. It is concluded that Alzheimer's Disease represents a complex phenomenon that requires integrated and interdisciplinary approaches, involving early diagnosis strategies, clinical interventions, and psychosocial support, in order to promote quality of life and delay the progression of cognitive impairment.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Bateman, R. J., et al. (2012). Clinical and biomarker changes in dominantly inherited Alzheimer’s disease. New England Journal of Medicine, 367(9), 795–804.

Braak, H., & Braak, E.. (1991). Neuropathological staging of Alzheimer-related changes. Acta Neuropathologica, 82(4), 239–259.

Brucki, S. M. D., et al. (2003). Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arquivos de Neuro-Psiquiatria, 61(3B), 777–781.

Carstensen, L. L., et al. (2020). Emotional experience improves with age: Evidence based on over 10 years of experience sampling. Psychology and Aging, 35(5), 707–718.

Cummings, J., et al. (2019). Alzheimer’s disease drug development pipeline: 2019. Alzheimer’s & Dementia, 5, 272–293.

De Strooper, B., & Karran, E. (2016). The cellular phase of Alzheimer’s disease. Cell, 164(4), 603–615.

Dubois, B., et al. (2014). Advancing research diagnostic criteria for Alzheimer’s disease: The IWG-2 criteria. Lancet Neurology, 13(6), 614–629.

Fan, L., et al. (2020). Tau pathology in Alzheimer’s disease: Mechanisms and therapeutic strategies. Journal of Alzheimer’s Disease, 75(4), 1239–1257.

Fiske, A., Wetherell, J. L., & Gatz, M.. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389.

Folstein, M. F., Folstein, S. E., & McHugh, P. R.. (1975). Mini-mental state: A practical method. Journal of Psychiatric Research, 12(3), 189–198.

Gaugler, J., et al. (2022). 2022 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 18(4), 700–789.

GBD Dementia Forecasting Collaborators. (2022). Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050. The Lancet Public Health, 7(2), e105–e125.

Holt-Lunstad, J., et al. (2015). Loneliness and social isolation as risk factors for mortality. Perspectives on Psychological Science, 10(2), 227–237.

Husain, M., et al. (2021). Neurodegeneration in Alzheimer’s disease. Nature Reviews Neurology, 17, 123–135.

Ismail, Z., et al. (2022). Neuropsychiatric symptoms in Alzheimer’s disease. Nature Reviews Neurology, 18(7), 389–405.

Jack, C. R., et al. (2018). NIA-AA research framework. Alzheimer’s & Dementia, 14(4), 535–562.

Jang, H., et al. (2021). Behavioral symptoms in Alzheimer’s disease. Journal of Clinical Neurology, 17(3), 303–312.

Lenze, E. J., et al. (2001). Anxiety disorders in the elderly. Depression and Anxiety, 14(2), 86–93.

Lezak, M. D., et al. (2012). Neuropsychological assessment (5th ed.). Oxford University Press.

Livingston, G., et al. (2020). Dementia prevention, intervention, and care. The Lancet, 396, 413–446.

Lupien, S. J., et al. (2009). Effects of stress on the brain. Nature Reviews Neuroscience, 10(6), 434–445.

Masters, C. L., et al. (2015). Alzheimer’s disease. Nature Reviews Disease Primers, 1, 15056.

McKhann, G. M., et al. (2011). Diagnosis of Alzheimer’s disease. Alzheimer’s & Dementia, 7(3), 263–269.

Murray, M. E., et al. (2011). Neuropathologically defined subtypes. Lancet Neurology, 10(9), 785–796.

Nasreddine, Z. S., et al. (2005). The Montreal Cognitive Assessment (MoCA). Journal of the American Geriatrics Society, 53(4), 695–699.

Petersen, R. C.. (2014). Mild cognitive impairment. Nature Reviews Disease Primers, 1, 15053.

Santini, Z. I., et al. (2020). Social isolation and mental health. The Lancet Public Health, 5(1), e62–e70.

Schilling, L. P., et al. (2022). Consenso brasileiro de demências. Dementia & Neuropsychologia, 16(1), 1–20.

Selkoe, D. J., & Hardy, J.. (2016). The amyloid hypothesis. EMBO Molecular Medicine, 8(6), 595–608.

Smid, J., et al. (2022). Consenso brasileiro de demências. Dementia & Neuropsychologia, 16(1), 1–20.

Sperling, R. A., et al. (2011). Preclinical Alzheimer’s disease. Alzheimer’s & Dementia, 7(3), 280–292.

Villemagne, V. L., et al. (2013). Amyloid imaging. Lancet Neurology, 12(4), 357–367.

Whitwell, J. L., et al. (2012). Neuroimaging correlates. Brain, 135(1), 235–247.

World Health Organization. (2022). Dementia: A public health priority. World Health Organization.

World Health Organization. (2023). Global status report on dementia. World Health Organization.

Published

2026-05-15

Issue

Section

Health Sciences

How to Cite

Alzheimer’s disease in aging: Neurobiological and clinical aspects and contemporary challenges for early diagnosis. Research, Society and Development, [S. l.], v. 15, n. 5, p. e5915551085, 2026. DOI: 10.33448/rsd-v15i5.51085. Disponível em: https://rsdjournal.org/rsd/article/view/51085. Acesso em: 7 jun. 2026.