Pharmacological Approaches of Alzheimer's Disease: An Update

Alzheimer's disease (AD) is the fourth major cause of death in the developed countries and it is the most common neurodegenerative disorder and the most prevalent cause of dementia with ageing. AD is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction; particularly in cholinergic neurons. The identification of disease causing autosomal dominant mutations as well as gene polymorphisms that alter the risk for pathology indicates that, it is a genetically complex disorder. This progress in our understanding of the molecular pathology has set the stage for clinically meaningful advances in diagnosis and treatment. Novel drugs that are currently in use or undergoing trial are briefly reviewed. To date, only a few acetylcholine esterase inhibitors have been licensed for AD, but more beneficial drugs are being actively sought by many different approaches. The development of additional drugs requires greater basic research on the pathogenesis of AD. Future therapeutic strategies for AD on the basis of recent findings concerning the pathogenesis of AD are also reviewed. Here, we review clinical features of the available cholinesterase inhibitors including their pharmacological properties and the emerging evidence for the use of memantine in AD. New therapeutic approaches including those more closely targeted to the pathogenesis of the disease will also be reviewed. Current treatments are briefly reviewed, followed by an introduction to emerging disease-modifying therapies.