The introduction of acetylcholinesterase inhibitors has greatly improved therapeutic opportunities for patients with dementia, in particular with Alzheimer’s disease. The most likely outcome of treatment with these compounds is a maintenance of cognitive ability and/or activities of daily living over at least 6 months.
Regarding the progressive nature of the underlying neurodegenerative process a temporary stabilization of symptoms is a clear treatment success. Approximately 25 per cent of patients experience a significant improvement in cognitive ability. They show more attentiveness, interest, activity, orientation, communicative ability, as well as better memory.
In addition, the new medications can ameliorate non-cognitive symptoms including apathy, agitation, delusions, hallucinations, and disinhibition. Open-label long-term studies have demonstrated that patients receiving treatment with an acetylcholinesterase inhibitor cross their baseline cognitive ability at week 40 to 50 and continue to decline thereafter.
In spite of this slow deterioration treated patients perform better than untreated individuals. Since ethical reasons do not permit to include placebo control groups in long-term trials it is not known presently how long the benefit from treatment lasts.
Source: Z Gerontol Geriatr 1999 Jun;32(3):167-71
PMID: 10436496, UI: 99365549
(Klinik fur Psychiatrie und Psychotherapie Technische Universitat Munchen.)