Anti-dementia drugs: what difference do they make?

Abstract

Alzheimer’s disease (AD) is a treatable disorder. Two classes of anti-dementia agents have emerged in the recent past: anti-oxidants and cholinesterase inhibitors. A recent study showed that the anti-oxidants alpha tocopherol (vitamin E) and selegiline slowed the progress of AD. Patients treated with either agent alone or with both agents in combination progressed to end-point more slowly than patients on placebo. Patients on placebo reached one of the end-points - death, nursing home placement, progression to severe AD, or significant loss of activities of daily living - in approximately 400 days, whereas patients on active agent required approximately 600 days to reach the same end-points. Both these agents have anti-oxidant properties; selegiline is a monoamine oxidase-B inhibitor that reduces free radical generation and alpha tocopherol has free radical capture capabilities. These agents are applied to patients in mild or moderate phases of AD, where slowing the progression of the illness and maintenance of patients at higher levels of function are the principal goals. Slowing the progression of the disease in more advanced phases of the illness may be less desirable.