Dementia: where has 2005 taken us?

摘要

This has been an exciting year across many fronts in dementia, but as space is limited I am restricting myself to the realm of treatment, mainly for Alzheimer's, disease.Despite, I suspect, the wishes of many, the cholinesterase inhibitors seem unwilling to lie down and die. They are moving into new pastures, including speculation that they could have a disease modifying-ie, neuroprotective-rather than just a symptomatic effect. An MRI study has reported that patients receiving donepezil had less hippocampal atrophy than controls.1 In a similar study, reduced loss of grey matter on MRI imaging was shown for a cholinesterase inhibitor that targets both acetylcholinesterase and butyrylcholinesterase. Although these findings complement preclinical studies that indicate that cholinesterase inhibitors can attenuate neuronal damage, it is probably too early yet to conclude that these drugs are indeed disease modifying.