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While current therapy for AD is indicated
for symptomatic treatment only, hopes persist that some therapies
may also have neuroprotective effects. In a prospective study
(Hashimoto et al ) of AD patients who underwent MRI imaging
twice at a one year interval, patients treated with donepezil
were compared to untreated controls with respect to hippocampal
atrophy. Donepezil treated patients experience 24% less atrophy
compared with untreated patients, leading the authors to suggest
that donepezil has neuroprotective effects. In a large randomized
placebo-controlled trial of raloxifene for osteoporosis, Yaffe
et al reported that at doses of 120 mg/day there were
33% fewer women who developed mild cognitive impairment over
a three-year period compared to placebo-treated patients. There
were also fewer women treated with raloxifene who developed
AD in this study, although the numbers were too small to draw
significant conclusions. The disease modifying effect of raloxifene
must now be confirmed in another study that focuses on MCI or
AD incidence as a primary outcome.
Does donepezil treatment slow the
progression of hippocampal atrophy in patients with Alzheimer’s
disease?
(AM J PSYCHIATRY 2005;162:676-682)
MAMORU HASHIMOTO, MD, PHD,
HIROAKI KAZUI, MD, PHD,
KEIJI MATSUMOTO, MD,
YOKO, NAKANO, MD, PHD,
ET AL,
HYOGO, JAPAN
Effect of raloxifene on prevention
of dementia and cognitive impairment in older women: the Multiple
Outcomes of Raloxifene Evaluation (MORE) randomized trial
(AM J PSYCHIATRY 2005;162:683-690)
KRISTINE YAFFE, MD,
KATHRYN KRUEGER, MD,
STEVEN R. CUMMINGS, MD,
TERRI BLACKWELL, MA,
ET AL,
SAN FRANCISCO, CA
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