Feldman HH, Ferris S, Winblad B, Sfikas N, Mancione L, He Y, Tekin S, Burns A, Cummings J, del Ser T, Inzitari D, Orgogozo JM, Sauer H, Scheltens P, Scarpini E, Herrmann N, Farlow M, Potkin S, Charles HC, Fox NC, Lane R. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol. 2007 Jun;6(6):501-12. PubMed.
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Medical University of Lodz, LZ, Poland
This paper "officially" completes the general failure of cholinesterase inhibitors in MCI. Two possible explanations emerge.
1. The MCI construct is not clinically valid and needs to be re-evaluated before other trials are started.
2. MCI is valid as a construct, but inhibitors are fundamentally a bad idea for such cases, because they disrupt compensatory mechanisms that are in force during this period of the dementing process.
For the interested reader, a meta-analysis of inhibitors in MCI is already published.
References:
Sobów T, Kłoszewska I. Cholinesterase inhibitors in mild cognitive impairment: a meta-analysis of randomized controlled trials. Neurol Neurochir Pol. 2007 Jan-Feb;41(1):13-21. PubMed.
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