Acetylcholinesterase inhibitors: Is this a useful therapy for Alzheimer's dementia?

The pros and cons of acetylcholinesterase inhibitors in the therapeutic treatment of Alzheimer's dementia are being widely discussed at present. For a better understanding of their effect the influence of acetylcholine on memory functions and the data suggesting a reduction of cholinergic neurons in AD will be described. The experience with the three most used cholinesterase inhibitors and the differences between the substances will be outlined. Moreover, the use of this treatment strategy in MCI patients and the results of a large MCI study will be presented. The current discussion on the use of these substances will be addressed in relation to cost effectiveness and the need for more efficient treatment approaches.