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2011 Grants - Devanand
Olfactory Deficits in MCI as Predictor of Improved Cognition on Donepezil
Davangere P. Devanand, M.D.
The Trustees of Columbia University
New York, NY
2011 Investigator -Initiated Research Grant
In the early stages of Alzheimer's disease, certain classes of nerve cells in the brain are especially vulnerable to degeneration. Many of these cells share the common feature that they use the chemical substance acetylcholine as a neurotransmitter. Neurotransmitters are crucial for brain function because they are released from one nerve cell to send messages to nearby cells, thereby propagating messages through the correct nerve pathways in the brain.
Loss of acetylcholine-using nerve cells is thought to account for some of the deficits in brain function in people with early-stage Alzheimer's disease. Indeed, the few drug treatments available for Alzheimer's disease inhibit the enzyme cholinesterase, which breaks down acetylcholine. By doing so, cholinesterase inhibitors increase acetylcholine levels in the brain and reduce the symptoms of disease.
Donepezil is one of the cholinesterase inhibitors in use for treatment of Alzheimer's symptoms. Unfortunately, it is expensive and only benefits some individualss. Preliminary studies have suggested that people with Alzheimer's who have impairments in their ability to identify odors are the most likely to benefit from donepezil treatment. The part of the brain that processes odors (the olfactory system) is one of the areas especially vulnerable to damage in people with Alzheimer's disease. Devangere P. Devanand, M.D. and colleagues have proposed to formally test whether people with Alzheimer's who have impaired ability to identify odors are more likely to benefit from donepezil treatment than individuals who do not have this impairment. This study could provide a way to identify individuals most likely to benefit from treatment, potentially saving unnecessary treatments and expense.