AD also exacts a severe indirect toll on caregivers who experience emotional, physical, and financial stressors. To date, no prospective studies exist regarding the economic weight of AD treatment, especially with respect to cholinesterase inhibitors. Only uncontrolled data are available. A recent retrospective cost-analysis study70 showed that use of tacrine resulted in this website savings of $10 000 per patient, from diagnosis to death. Another recent study71 showed that 5% of donepezil-treated

AD patients Inhibitors,research,lifescience,medical were institutionalized at the end of a 6-month period, compared with 10% of those not receiving donepezil. Future directions Future therapeutic approaches72 to the treatment of patients with AD include applying functional brain imaging techniques in early diagnosis and evaluation of treatment efficacy (in vivo measurements of cholinesterase function,73 and developing preventive methods, such as Ap immunizations74 and inhibitors of β-secretase75 and γ-secretase.76

Repetitive immunizations of APP Inhibitors,research,lifescience,medical transgenic mice with Aβ produces antibodies that seem to promote the clearance of Aβ deposits from the brain. This approach is now being Inhibitors,research,lifescience,medical used in phase 1 clinical trials. Conclusions Current treatment approaches to dementia arc based on variable degrees of scientific evidence, reflecting an incomplete understanding of the basic pathophysiology of AD. Cholinergic deficits have been well described and evidence is sufficiently consistent to make cholin-esterase inhibitors (donepezil, tacrine, rivastigmine and galantamine) the recommended treatment of cognitive disturbance in patients with AD. Symptomatic Inhibitors,research,lifescience,medical treatment mainly focusing on cholinergic therapy has been clinically evaluated Inhibitors,research,lifescience,medical by randomized, double-blind, placebo-controlled, parallel-group studies measuring performance-based tests of cognitive function, activities of daily living, and behavior. Cholinesterase

inhibitors may treat behavioral disturbances. Treatments with antioxidants, anti-inflamma tory agents, and estrogen replacement therapy are still controversial, although clinical trials exploring their effectiveness are under way. Antidepressants, antipsychotics, mood stabilizers, anxiolytics, and hypnotics are used for symptomatic treatment of behavioral disturbance. Selected abbreviations and acronyms Aβ amyloid β-peptide AD Alzheimer’s those disease ADAS-cog cognitive subscale of the Alzheimer’s Disease Assessment Scale APOE apolipoprotein E APP amyloid precursor protein CIBIS Clinician Interview-Based Impression Scale COX-2 cyclooxygenase-2 ERT estrogen replacement therapy MMSE Mini-Mental State Examination NSAID nonsteroidal anti-inflammatory drug PS 1 & 2 presenilin-1 & -2 SSRI selective serotonin reuptake inhibitor
Approximately 10% of persons who reach the age of 65 will develop Alzheimer’s disease (AD) or another type of dementia.