Alzheimer's disease (AD) is the most common cause of mental impairment
in late life and is estimated to afflict nearly half of older adults
who live beyond age 85. Although progressive dementia is a cardinal fe
ature of patients with AD, age at symptomatic onset, rate of progressi
on, and specific signs and symptoms vary widely. This clinical heterog
eneity appears to arise in part from interindividual differences in th
e precise molecular events that contribute to the pathophysiology of A
D, as well as from nonuniform or multifocal patterns of brain degenera
tion that occur during the early to middle stages of dementia. The goa
ls of this review are to cover the substantial progress that has been
made over the past 5 years in the major thematic areas of research in
AD and to assemble these individual findings into a more integrated pi
cture of the pathophysiology of the disorder. The results may have imp
ortant implications for the treatment or prevention of AD.