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when your wife got lost driving to the neighborhood market. Or when your father

received a cut-off notice because a utility bill was not paid for two months. Up

to that point you thought the forgetting was “normal aging”—a series of

“senior moments”; now you can no longer deny that someone you love has

doctor’s appointment…a discussion of recent problems with memory, judgment

and functioning…some medical tests; then, the terrible moment when the doctor

is the loss of thinking abilities that were mastered early in childhood. These

abilities include memory, the ability to perform multi-step tasks, the use of

language as well as higher order functions like judgment, planning and

organizing. There are a number of diseases that can cause this impairment. The

most common causes include Alzheimer’s disease, multi-infarct dementia and

diffuse Lewy body disease. Each of these illnesses shows a different pattern of

dementia can’t be cured, there are now treatments that can make a significant

difference in the course of the illness. A group of medications called “acetylcholinesterase

inhibitors” works by boosting the strength of signals that are sent by

nerves within the brain using the chemical messenger, acetylcholine. It is

surprising that while these medications were developed for treatment of

Alzheimer’s disease, there are growing reports that they help other forms of

commonly used medications, donepezil (Aricept®), rivastigmine (Exelon®) and

galantamine (Reminyl®) don’t change the course of the illness. However in

adequate doses they restore cognitive functioning to where it was about 9 months

previously. While that may not seem like much, consider for example the person

who has just started to have trouble caring for himself. With such medication,

aren’t generally dangerous. Nausea and diarrhea are common side effects.

Because of this, small starting doses are generally increased gradually as

these medications can restore the ability to recognize family members, to

socialize or to care for themselves, at a point where these abilities were