The primary caregiver's denial often plays a role in delaying seeking a definitive diagnosis. One study found that diagnosis was more delayed in female patients, taking an average of 34.9 months after symptom onset. 11 Most AD experts believe that patients and families should be told the diagnosis as soon as possible because they have the right to know how living with the disease will affect them. An early diagnosis allows the patient to participate in major decisions about care while he or she is still able. Most patients would want to be informed of their diagnosis, according to a study of older people's attitudes about being told they have AD or terminal cancer.
AD causes dysfunction of the cholinergic system, which is involved in human cognition.
Therefore, many clinical trials of AD treatments focus on cholinergic agents. 13 Drugs available for AD by prescription or in clinical trials temporarily improve memory and cognitive abilities for people in the mild to moderate stages of the disease. Neurotransmitter enhancers increase communication between nerve cells by mimicking the work of neurotransmitters or by preventing their breakdown. Because of the risk of hepatic toxicity, patients on tacrine need to have their transaminase levels checked weekly for the first few months of therapy or when the dose is increased. 3,14 Metabolic enhancers help keep nerve cells healthy by maintaining their proper functioning.