Types of AD
| Clinical Scenario | Core ICD-10 Codes | Add-on Codes/Notes |
|---|---|---|
| Early-onset (DIAD/EOAD) | G30.0 | F02.8x, genetic variant in note |
| Late-onset (LOAD) | G30.1 | F02.8x, note ApoE4 & PRS |
| Down’s + Alzheimer’s | Q90.x + G30.x | F02.8x for dementia |
| Mixed: AD + LBD | G30.x + G31.83 | F02.8x or F03.x |
| AD + Vascular Dementia | G30.x + F01.x | F02.8x |
| AD + Prion Disease | G30.x + A81.0 | F02.8x |
| AD with Herpes Simplex | G30.x + B00 | F02.8x if dementia |
| AD with Substance Use | G30.x + F10–F19 | F02.8x |
| Sporadic/Recessive AD | G30.8 | F02.8x |
| Unspecified AD | G30.9 | F03.x |
Definitions
- DIAD – Dominantly inherited Alzheimer’s Disease (APP, Presenilin 1, or Presenilin 2 pathological variants)
- Trisomy 21 = Down’s Syndrome – resulting in 3 APP genes.
- ApoE4 homozygotes – EOAD Early Onset Alzheimer’s Disease
- ApoE4 heterozygotes with high polygenic risk scores – LOAD Late Onset Alzheimer’s Disease
- Sporadic Non ApoE4 and non DIAD
- Post Herpes Zoster recurrence related Alzheimer’s Disease.
- Recurrent Human Herpes Simplex 1 or 2 related Alzheimer’s Disease
- Other Cerebral Virus or Bacterial Infection related Alzheimer’s Disease ( Influence Virus, COVID-19, Hepatitis C, HIV, Lyme Disease, and/or oral bacteria )
- Rare Sporadic Recessively inherited Alzheimer’s Disease (SORL1 or TREM2)
- Mixed Dementia includes all cases that involve -Alzheimer’s Disease along with FTD-frontotemporal lobe dementia, LBD -Lewey body disease – Parkinson’s Disease, ALS – Amyotropic Lateral Scerosis, CAA- Cerebral Amyloid Angiopathy, LATE – Limbic-predominant Age-related TDP-43 Encephalopathy, Prion Diseases, Vascular Dementia – Loss of Type I nNOS excitatory Neurons, Multiple Sclerosis and/or Substance Use Disorders.
Stage models for Alzheimer’s Disease :
- 3 Stage Model
- 7-Stage Model (Global Deterioration Scale)
- Biomarker-Based 3-Phase Model (NIA-AA 2011 Criteria)
- Braak Staging Model
- Genetic profile or Disease Category Specific Staging Model
Dementia/Alzheimer’s Disease Clinical Guidelines
San Diego County Alzheimer’s Project
Schedule an Online Appointment for Cognitive Assessments, Blood Testing, Imaging, or Continuous Monitoring with Dr. Carr.
- Mini-Cog, and the MiniMental Status Exam
- ApoE genotyping and Polygenic Risk Factor Assessment
- Biomarker testing : Blood pTau217, Amyloid Beta 40/42 Ratio, CSF markers or under development
- General physical 100 Biomarker Blood Panel
Imaging
- Retinal Scanning for AI Assisted Early Diagnosis
- beta amyloid PET Brain Scan
- Tau Pet Brain Scans
- TSPO-Neuroinflammation Biomarker PET Scans
Schedule an Online Appointment for a Personalized Treatment Plan
Healthy Body, Healthy Mind & Tools for Navigating Dementia
| Treatment : Mechanism of Action |
| Omega 3 fatty acids , Superoxide Anion Detoxifiers/Production Inhibitors – Reducing Neuroinflammation |
| Stimulating Glymphatic Drainage of the Brain during Deep Sleep through prevention of AQP4 delocalization in periarterial Astrocyte Endfeets. |
| Lithium Orotate – Glycogen Phosphate Kinase beta inhibitor |
| Polyphenols –Anti Tau and Amyloid beta protein aggregation |
| Probiotic Nutritional Fibers with enteric microbiome metabolization: Ferulic Acid, Butyrate, and Short Chained Fatty Acids |
| Womens supplements |
| Vitamin D3, K2, and Mg – General Nutrition |
| Vitamin B12 – Brain Nutrients |
| Anti amyloid protein antibody injections |
| BACE1 aspartate protease inhibitors, |
| Plasminogen protein infusions |
| Acetylcholine Esterase Inhibitors |
| Incretins – GLP-1 – GIP agonists |
| Varicella Zoster Vaccine – Vaccinations against Neurotropic Viruses or Bacteria |
| SGLT2 inhibitors |
| C1q complement cascade -Inhibitors or Enhancers |