Forgetting recent conversations, appointments or events, repeatedly asking the same questions, or increasingly relying on reminders for information that was previously remembered without difficulty.

Becoming disoriented in familiar places, having difficulty following a familiar route, or progressively losing track of dates and the passage of time.

Difficulty finding certain words, following a conversation or clearly expressing an idea that could previously be communicated without difficulty.

Problems organising activities, managing finances, following instructions or carrying out everyday tasks that were previously familiar.

Apathy, irritability, loss of initiative, social withdrawal or other changes in behaviour that are unusual for the person may appear.

As the disease progresses, difficulties may arise in independently carrying out familiar everyday tasks, both at home and outside the home.

The assessment begins with a detailed medical history and neurological examination. A neuropsychological assessment provides an objective evaluation of memory and other cognitive functions, including attention, language, executive functions and orientation.

These tests help determine which abilities are affected, establish the severity of the impairment and distinguish between normal ageing, mild cognitive impairment, Alzheimer’s disease and other possible causes.

Advances in biomarkers are making it possible to obtain increasingly detailed information about the biological processes associated with Alzheimer’s disease through a blood test.

These include p-tau217, a biomarker associated with the amyloid and tau protein changes characteristic of the disease. Measuring p-tau217 can help identify patients with a high probability of having Alzheimer’s pathology and determine when further testing is needed to complete the diagnostic assessment.

Blood biomarkers should not be interpreted in isolation: their results must be assessed within the clinical context by specialists experienced in cognitive disorders.

Neuroimaging tests make it possible to assess brain changes associated with Alzheimer’s disease and rule out other possible causes of the symptoms. A brain MRI can identify structural abnormalities and is also important when assessing the suitability and safety of certain new treatments. In selected cases, a brain PET scan can be used to assess brain metabolism or detect proteins associated with the disease, such as beta-amyloid, helping to confirm the presence of amyloid pathology in the brain.

Analysis of cerebrospinal fluid obtained through a lumbar puncture makes it possible to assess biomarkers related to beta-amyloid and tau and obtain precise information about the biological processes characteristic of Alzheimer’s disease.

It can be used to confirm the diagnosis when the patient’s characteristics or the results of other tests indicate that further assessment is necessary.

In selected cases, genetic testing may be indicated, particularly when there is a family history of the disease or when Alzheimer’s develops at an unusually young age.

Genetics has also become important for certain disease-modifying treatments. ApoE genotyping may be necessary to assess whether a treatment is appropriate and to estimate certain treatment-related risks.

The introduction of treatments targeting the beta-amyloid protein represents an important change in the treatment of Alzheimer’s disease. Unlike medications used to relieve certain symptoms, these new therapies aim to act on the underlying course of the disease and slow cognitive and functional decline.

New medicines are now authorised in Europe for certain patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease, provided they meet specific clinical and biological criteria.

Lecanemab is a monoclonal antibody targeting beta-amyloid that has been shown to slow cognitive and functional decline in certain patients with early Alzheimer’s disease.

Before treatment can be considered, the presence of amyloid pathology must be confirmed and a specialist assessment is required to determine whether the patient meets the necessary criteria and can receive the treatment safely.

Donanemab is another treatment targeting beta-amyloid that is authorised for certain patients with early-stage Alzheimer’s disease. Its aim is to reduce amyloid plaques accumulated in the brain and slow the progression of the disease.

As with Lecanemab, a specialist assessment is required before starting treatment to confirm whether it is indicated and establish the appropriate treatment and follow-up protocol.

In addition to the new disease-modifying therapies, there are medications that can treat certain symptoms of Alzheimer’s disease and help maintain cognitive and functional abilities for longer.

These include acetylcholinesterase inhibitors, such as donepezil, rivastigmine and galantamine, as well as memantine. Their use depends on the stage of the disease and the individual characteristics of each patient.

Pharmacological treatment should be reviewed regularly to assess its effectiveness, tolerability and suitability as the disease progresses.

Alzheimer’s treatment also includes interventions designed to maintain cognitive abilities, independence and quality of life for as long as possible.

Cognitive stimulation, physical exercise, speech and language therapy when indicated, a healthy diet, maintaining social relationships and adapted daily routines may all form part of the treatment plan.

These interventions are tailored to each patient’s individual situation and disease progression and complement pharmacological treatment.

Alzheimer’s is a progressive disease, and patients’ needs change over time. Specialist follow-up therefore makes it possible to adapt treatment, identify new needs and anticipate potential complications.

Support also extends to family members and caregivers, providing information and guidance to help them understand the progression of the disease and manage the changes that may arise at different stages.

The Memory and Cognitive Disorders Unit at barnaclínic+ includes professionals specialising in Alzheimer’s disease, cognitive impairment and other forms of dementia, with extensive experience in their diagnosis, treatment and follow-up.

Our multidisciplinary approach makes it possible to jointly assess the neurological, cognitive and functional aspects of each patient and establish a care strategy tailored to their individual needs.

The introduction of new treatment options for Alzheimer’s disease has expanded the therapeutic possibilities for certain patients in the early stages of the disease.

Our team can carry out the necessary assessment to determine whether a patient meets the criteria for these new treatments and, when they are indicated and available, plan their administration and specialist follow-up.

Not all patients with Alzheimer’s disease experience the same progression or have the same needs. Treatment is therefore tailored to each individual and reviewed regularly to adapt it to changes in their clinical and cognitive condition.

Our aim is to provide the most appropriate diagnostic, therapeutic and support options for the patient and their family at every stage.

Patients living outside Barcelona or in other countries can have an initial assessment via video consultation, provide their available medical reports and test results, and receive guidance on the next steps.

When diagnostic tests or treatments need to be carried out in person, our team can organise and coordinate the care process in Barcelona.

The specialists at barnaclínic+ work within the Hospital Clínic de Barcelona environment, a leading centre in neurology, Alzheimer’s disease and other cognitive disorders.

This connection enables private patients to benefit from the clinical experience and knowledge generated within a hospital environment with extensive clinical, teaching and research activity in neurodegenerative diseases.