Drug Treatment of Alzheimer’s Disease

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder with characteristic clinical and pathological features.1 It is now recognised as the most common dementing disorder in the elderly.2 Age is one of the greatest risk factors for developing AD with nearly 50% of those over 85 years affected.1,2,3 AD affects approximately 33,000 Irish people.4 Epidemiological studies have shown a higher incidence of AD in women, the risk being 1.2-3.5 times greater than in men.5 Other risk factors include family history, presence of apolipoprotein E4 allele and mutations of chromosomes 1, 14 and 21.1,2,5 Management of these patients presents a multidisciplinary challenge. Possible, but not proven, protective factors against AD include the use of oestrogen replacement therapy, use of NSAIDs, education and challenging occupations.6 Recently two agents have been licensed in Ireland for the treatment of this condition namely donepezil and rivastigmine.