Prodromal stages show an independent association while the mild-moderate stages of AD showed association with frailty transition as well as aging and cognitive degeneration (2). Diagnostic workup for AD is physical and neurological assessment, and blood analysis (9). Besides biomarker-based tests in CSF analysis and brain imaging using CT scan or MRI, Mini Mental State Examination (MMSE) and Addenbrooke’s Cognitive Examination (ACE) are commonly used as cognitive screening (9). Hippocampus atrophy serves a predictor for the conversion of mild cognitive impairment to AD dementia (3). Wood et al. (2016) suggest an additional test that relies on the role of hippocampus in allocentric spatial memory called 4 Mountains Test (4MT) (11). The ten minutes test is easily conduct in paper form or in an Ipad app, which test the patient ability to recognize the same landscape image form 4 different viewpoint with different topography (11). The brief and easy application of the 4MT is “suited for use as a diagnostic test for pre-dementia AD not only in specialist clinics but also in non-specialist diagnostic practice, such as primary care clinics and community-based memory assessment services” …show more content…
Presenting symptoms commonly seen in Alzheimer patients are “ delusions, agitation, depression, anxiety, disinhibition, irritability, hallucination, apathy, aberrant motor behavior, sleep disturbances, and eating abnormalities” (1). Disease progression eventually leads to language problems, difficult behavior, mood swings, and disorientation (8). Ultimately, the patient will progressively lose their ability to perform daily activities as neuropsychological problems develop (8). People with dementia including AD are susceptible to pneumonia and most likely to die from pneumonia due to the use of antipsychotic agents (online). The comparison between different antidementia drugs that commonly use by AD patient revealed the highest risk associated with pneumonia is Memantine