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May 14, 2003

Cholinesterase Inhibitors for Alzheimer Disease

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(18):2359. doi:10.1001/jama.289.18.2359-a

In Reply: We agree with Drs van Gool and Lemstra that certain patients may respond preferentially to ChIs. Indeed this may be true for both the cognitive and neuropsychiatric symptoms. For example, it may be that certain genetic or environmental factors determine whether patients with AD respond to ChIs or influence the amount of their response. Similarly, Dr Finucane's comments regarding the importance of assessing caregiver burden or quality of life are especially important. Unfortunately, we were unable to identify subsets of patients or quantify the effects of ChIs on quality of life or caregiver burden due to lack of data presented in the primary trials. Nonetheless, as we stated in our article, we feel these are important areas for future investigation.

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