The impact of antidementia drugs on real life

The introduction of acetylcholinesterase inhibitors has greatly improved th erapeutic opportunities for patients with dementia, in particular with Alzh eimer's disease. The most likely outcome of treatment with these compounds is a maintenance of cognitive ability and/or activities of daily living ove r at least 6 months. Regarding the progressive nature of the underlying neu rodegenerative process a temporary stabilization of symptoms is a clear tre atment success. Approximately 25 per cent of patients experience a signific ant improvement in cognitive ability. They show more attentiveness, interes t, activity, orientation, communicative ability, as well as better memory. In addition, the new medications can ameliorate non-cognitive symptoms incl uding apathy, agitation, delusions, hallucinations, and disinhibition. Open -label long-term studies have demonstrated that patients receiving treatmen t with an acetylcholinesterase inhibitor cross their baseline cognitive abi lity at week 40 to 50 and continue to decline thereafter. In spite of this slow deterioration treated patients perform better than untreated individua ls. Since ethical reasons do not permit to include placebo control groups i n long-term trials it is not known presently how long the benefit from trea tment lasts.