Noncholinergic treatment options for Alzheimer's disease.

Approved treatments for Alzheimer's disease have focused primarily on cholinergic enhancement. New attention, however, is being turned toward preventative treatments such as vitamin E, estrogen, and lipid-lowering agents. Preventative treatments focus on intervening prior to the onset of disease. These treatments are designed to modify the amyloid load. These new approaches require designs that select nonimpaired or minimally impaired populations, using new outcomes with prolonged assessment. The cost of these studies is high, but the potential benefit of delay or prevention of disease is the valuable goal.