UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
Alzheimers Dement. 2011 Mar;7(2):177-84. doi: 10.1016/j.jalz.2010.03.016. Epub 2010 Nov 5.
Despite growing recognition that Alzheimer's disease (AD) represents a global public health and social care crisis, diagnosis is frequently slow and many patients still receive no treatment at all. Of those who do receive treatment, many remain on lower than recommended doses. The Alzheimer's disease International Global Charter promotes awareness and understanding of AD, stressing the importance of optimal treatment. However, the definition of "optimal treatment" is unclear. Since cholinesterase inhibitors became available nearly 20 years ago, clinicians have developed a variety of protocols on the basis of clinical experiences. This review considers what is optimal for several aspects of cholinesterase inhibitor therapy, taking into account initiation strategies, dosages, modes of drug delivery (e.g., oral vs. transdermal), and treatment durations. Regardless of management approach, individuals with AD, their families, and caregivers have a right to a timely diagnosis and access to best available treatment.
尽管人们越来越认识到阿尔茨海默病（AD）是全球公共卫生和社会保健危机，但诊断通常很慢，许多患者根本没有接受任何治疗。在接受治疗的患者中，许多人服用的剂量低于推荐剂量。《阿尔茨海默病国际全球宪章》提高了对 AD 的认识和理解，强调了最佳治疗的重要性。然而，“最佳治疗”的定义尚不清楚。自近 20 年前胆碱酯酶抑制剂问世以来，临床医生根据临床经验制定了各种方案。本综述考虑了在考虑启动策略、剂量、药物给药方式（例如口服与透皮）和治疗持续时间的情况下，几种胆碱酯酶抑制剂治疗方法的最佳情况。无论采用何种管理方法，AD 患者、他们的家人和照顾者都有权及时得到诊断并获得最佳可用治疗。
