Pharmacological treatment in moderate-to-severe Alzheimer's disease

Background: Moderate-to-severe stage Alzheimer's disease (AD) is a clinically diagnosable entity that represents a substantial burden to our healthcare system in terms of its prevalence, symptomatology, caregiver stress and economics. Objective: In this paper, we review the data from currently available clinical trials aimed at treatment of this later stage of the disease. Methods: A literature search was performed and published randomized controlled trials (RCTs) in which the majority of the study population consisted of Alzheimer patients in the mode rate-to-severe stage were selected for review. Results: A total of nine RCTs were identified in which the study population consisted of mainly moderate-to-severe AD patients. The results from these studies suggest that memantine and donepezil, individually or in combination, provide measurable global, cognitive and behavioral benefits in AD patients. Conclusion: Pharmacological treatment of moderate-to-severe AD patients can be beneficial. However, cost-benefit data are limited, and the long-term effects and the optimal duration of treatment as patients continue to progress to more severe stages are unknown and require further investigation.