Long-term treatment of mild to moderate Alzheimer disease in a 77-year-old female patient.

Alzheimer disease is characterized by a loss of cholinergic neurons in the basal forebrain and a decrease in acetylcholine levels. Currently, cholinesterase inhibitors, drugs that act by inhibiting the enzyme responsible for the hydrolysis of acetylcholine, are the only therapy for the treatment of Alzheimer disease approved by the Food and Drug Administration. The cholinesterase inhibitors have been shown to be effective in treating the cognitive symptoms of Alzheimer disease and in slowing functional decline. An early diagnosis of Alzheimer disease allows initiation of cholinesterase inhibitor therapy early in the disease course and could serve to lengthen the time during which the patient can function independently. The benefits of early diagnosis and initiation of long-term cholinesterase inhibitor therapy are illustrated in the case of a 77-year-old woman residing in an assistedliving facility who had cognitive impairment. Mild Alzheimer disease was subsequently diagnosed and treated with a cholinesterase inhibitor for 3 years.