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A study published in the December 2004 Archives of Neurology1 reports that early treatment of patients experiencing cognitive decline with drugs such as Aricept (donepezil) is beneficial and shows promise for preserving cognitive abilities. Aricept, a cholinesterase inhibitor, enhances cholinergic function by increasing levels of acetylcholine in the body.


The 24-week efficacy study of intent-to-treat and fully evaluable patients found that 70% of patients taking Aricept avoided cognitive decline symptoms as measured by the Mini-Mental State Exam, the Alzheimer's Disease Assessment Scale, the Clinical Dementia Rating Scale, and other tests.


Patients taking Aricept exhibited performance improvements on verbal and visual memory tests as well as apathy scores.


According to the Fisher Center for Alzheimer's Research, previous studies of Aricept found that while the improvements in memory and thinking afforded by the drug lasted at least 2 years in most patients, overall Aricept did not prevent downward progression of the disease. In a 5-year study conducted in the United Kingdom, participants became steadily less able to care for themselves, and similar numbers of patients from the Aricept and placebo groups entered nursing homes.


The current study evaluated a group of patients whose symptoms were not as advanced as Alzheimer patients in previous studies, suggesting that the earlier a diagnosis is made, the more effective drugs such as Aricept may be at preventing Alzheimer symptoms and preserving cognitive function. In addition, according to the article, imaging studies have found smaller decreases in hippocampal volume due to Alzheimer in patients taking Aricept.


The Fisher Center has also reported that atorvastatin (Lipitor), one of a class of drugs used to reduce total and low-density lipoprotein cholesterol levels in the blood, may be part of a possible remedy for Alzheimer. A year-long study found that 53% of patients taking Lipitor as well as an Alzheimer drug such as Aricept scored higher on tests that measured memory and thinking skills.


Statins may lower cholesterol buildup in the brain and inhibit accumulation of [beta]-amyloid proteins, which damage nerve cells in cognitive and memory centers. Each one affects brain chemistry differently, however, and so each one of the statins (lovastatin, prevastatin, simvastatin, and fluvastatin) will have to be tested individually.


The Fisher Center cautions that while these drugs hold promise for the treatment of Alzheimer disease, palliative and supportive care for patients and family members is equally important and also provides powerful benefits.






1. Seltzer B, Zolnouni P, Nunez M, et al., Arch Neurol. 2004;61:1852-1856. [Context Link]