Cognitive function in Alzheimer’s disease

Oken BS, Storzbach DM, Kaye JA. The efficacy of Ginkgo biloba on cognitive function in Alzheimer s disease. Arch Neurol 1998 55 1409-1415. 

Subaiea GM, Adwan LI, Ahmed AH, Stevens KE, Zawia NH (2013) Short-term treatment with tolfenamic acid improves cognitive functions in Alzheimer s disease mice. Neurobiol Aging 34 2421-2430... 

Konishi K, Hori K, Uchida H, Watanabe K, Tominaga I, Kimura M, Hosoyamada M, Shibasaki T, Kataoka A, Hachisu M. Adverse effects of anticholinergic activity on cognitive functions in Alzheimer s disease. Psychogeriatrics 2010 10(1) 34-8. 

Rogers SL, Doody RS, Mohs RC, et al Donepezil improves cognition and global function in Alzheimer s disease a 15-week, double-blind, placebo-controlled study. The Donepezil Study Group. Arch Intern Med 158 1021-1031, 1998a... 

Sometimes, the severity of the cognitive symptoms in Alzheimer s disease can be reduced, at least to some degree, by drugs and dietary nutrients that enhance the function of acetylcholine neurons in the brain. To understand how this is possible, we need to look at how acetylcholine is produced in the brain in the first place. 

Snowdon DA, Kemper SJ, Mortimer JA, Greiner LH, Wekstein DR, Markesbery WR (1996) linguistic ability in early life and cognitive function and Alzheimer s disease in late Rfe. Findings from the Nun Study. J Am Med Assoc 275 528-532 Sommer B (2(X)2) Alzheimer s disease and the amyloid cascade hypothesis ten years on. Curr Opin Pharmacol 2 87-92... 

Newhouse, P.A., Potter, A., Corwin, J. et al., 1996. Effects of nicotinic cholinergic agents on cognitive functioning in Alzheimer s and Parkinson s disease. Drug Dev. Res. 38, 278-289. 

Galanthamine is the only alkaloid of this class that has already found apphcation in medicine. It is approved for the symptomatic treatment of Alzheimer s disease in Europe and the United States. Its mode of action consists in a competitive and reversible inhibition of acetylcholinesterase, which leads to an increased concentration of acetylcholine at neuronal synapses. In addition, galanthamine acts as an allosteric modulator on nicotinic acetylcholine receptors. Since a characteristic featnre of Alzheimer s disease is the loss of acetylcholinergic neurons concomitant with decreased levels of acetylcholine, galanthamine can, at least partially, compensate the damage and thus enhance cognitive functions in Alzheimer s patients. 

Frontotemporal dementias are characterized by gross structural changes in the frontal and anterior temporal lobes, metabolic disturbances, and involvement of certain subcortical structures as well (Ishii et al. 1998). Whereas in Alzheimer s disease the early cognitive disturbances are in memory, in frontotemporal dementias the early manifestations are in executive and behavioral function (Pfeffer et al. 1999 Varma et al. 1999). This relative cognitive distinction persists throughout the course of the two disorders (Pachana et al. 1996). Disinhibition and disorganization are common, and psychotic symptoms may be prominent in frontotemporal dementia. 

Huff FJ, Mickel SF, Corkin S, et al Cognitive functions affected by scopolamine in Alzheimer s disease and normal aging. Drug Development Research 12 271-278, 1988... 

Molloy DW, Guyatt GH, Wilson DB, et al Effect of tetrahydroaminoacridine on cognitive function and behaviors in Alzheimer s disease. Canadian Medical Association Journal 144[l 29-34, 1991... 

FIGURE 11—54. Cognitive symptom pharmacy. Atypical antipsychotic dmgs (SDA) may improve cognitive functions in both schizophrenic and Alzheimer patients (first-line treatment). They may boost the actions of cholinesterase inhibitors (ChEIs) in Alzheimer s disease. It may also be useful to discontinue any anticholinergic medication that you can, a welcome bonus when switching from conventional antipsychotics to atypical antipsychotics (decreased A Ch). 

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