Abstract
Alzheimer’s disease (AD) is characterized by a gradual decline in 3 domains: cognition,
behavior, and function. Ideally, an effective treatment would target all 3 types of
impairment. However, available treatments for AD diminish only certain symptoms and
cannot halt the dementing process. Most pharmacologic agents currently available or
in development target a specific symptom cluster (e.g., cognitive loss), and are based
on the known neurobiology of the disease (e.g., neurotransmitter deficit) or hypothesized
antidementia approaches (e.g., anti-inflammation, antioxidation). Two currently available
cholinesterase inhibitors improve memory and other aspects of cognition during short-term
treatment. Additional cholinergic agents will soon become available. Other promising
agents under study for cognitive enhancement or protection include vitamin E, selegiline,
estrogen, and nonsteroidal anti-inflammatory drugs. As scientists uncover the basic
pathogenetic mechanisms of AD, additional treatments will likely emerge. Therapies
for behaviors associated with dementia (e.g., depression, agitation, anxiety) are
sometimes effective. Choices of specific medications, including antidepressants, antipsychotics,
and anxiolytics, depend on specific side-effect profiles. Psychotherapies aimed at
enhancing cognition are ineffective for dementia but nonpharmacologic interventions
may minimize depression and agitation and may improve quality of life.
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Article info
Publication history
Published online: August 16, 2004
Footnotes
☆The views expressed are those of the investigator and do not necessarily represent those of the Department of Veterans Affairs.
☆Supported in part by The Fran and Ray Stark Foundation Fund for Alzheimer’s Disease Research.
Identification
Copyright
© 1998 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
