Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
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.
Trinh N, Yaffe K. Cholinesterase Inhibitors for Alzheimer Disease. JAMA. 2003;289(18):2359. doi:10.1001/jama.289.18.2359-a