Nicotine is widely recognized as an pharmacological agent that facilitates cognitive performance in human smokers as well as preclinical models utilizing rodents or non-human primates. Furthermore, epidemiological studies have consistently shown that the incidence of neurodegenerative diseases such as AD and Parkinson's Disease is lower in cigarette smokers than age-matched controls. These findings have prompted speculation that brain nicotinic receptors could be important therapeutic targets for Alzheimer's Disease. Few studies have controlled for the potential influence of cigarette smoking, which increases the density of nicotinic receptors in human smokers. Therefore, although the findings related to nicotinic receptors and AD to this date are intriguing, they appear to have raised more questions than they have answered.
Dementia constitutes a growing public health crisis.
Early and accurate diagnosis of dementia is essential in order to provide patient and family counseling and appropriate treatment, including with specific antidementia drugs as they become increasingly available. Age-related cognitive decline, as compared with dementia, does not seriously interfere with usual activities. The optimal approach to early detection of dementia is clinical examination that incorporates information from a reliable collateral source about how the patient s cognitive abilities have declined relative to past performance. Even incipient AD can be detected with clinical methods alone. Although the typical picture of AD is characterized by gradual onset and progression of memory and other cognitive deficits, in other respects the disease is marked by heterogeneity.