Donepezil for severe Alzheimer's disease

1conclude that donepezil improves cognition and pre serves function in nursing home patients with severe Alzheimer’s disease. Some points should be discussed before accepting this conclusion. Although Winblad and colleagues mention that a CT or MRI scan consistent with Alzheimer’s disease was required for entry into the study, such imaging is insuffi cient to distinguish Alzheimer’s disease from other types of dementia, especially vascular dementia resulting from cerebral ischaemia. It has been reported that applied fl uorodeoxyglucose positron emission tomography accurately separates vascular dementia from Alzheimer’s disease. 2 Additionally, abnormal levels of β-amyloid, tau, and a phosphorylated version of tau in cerebrospinal fl uid can distinguish Alzheimer’s disease from other types of dementia. 3