Alzheimer's disease: Seeking new ways to preserve brain function

Alzheimer's disease (AD) is characterized in the brain by the deposition of amyloid protein outside the neuron, resulting in the formation of plaques, and inside the neuron with neurofibrillary tangles. It is not yet known wh at causes these pathologic changes, although age and genetics are major ris k factors. The cholinesterase inhibitors tacrine and donepezil bloch acetyl cholinesterase and therefore preserve the neurotransmitter acetylcholine. T hree other Investigational cholinesterase inhibitors are rivastigmine, metr ifonate, and galanthamine. Existing therapies being studied for use in AD i nclude vitamin E, estrogen preparations, and anti-inflammatory agents. The physician's role is to care for both the AD patient and the family, which a re profoundly affected by this disease.