Donepezil for dementia due to Alzheimer's disease

Dementia is a syndrome of acquired deficits in multiple domains of cognition. These cognitive impairments can affect a person's memory, language, judgement, behaviour and ability to perform everyday activities. The clinical development of the disease is associated with increasing disability and dependency on carers, although this progressive deterioration is highly variable in different patients with dementia (Ritchie et al, 2017).

Alzheimer's disease is a primary degenerative cerebral disease of unknown origin and is the most common cause of dementia in older people (Apostolova, 2016). Acetylcholine is a vital neurotransmitter associated with memory, and abnormalities in cholinergic neurons, in which acetylcholine is the neurotransmitter, are clearly identified in the pathological changes in the brains of people with Alzheimer's disease. The drug donepezil inhibits the breakdown of acetylcholine by reversibly inhibiting the enzyme acetylcholinesterase, thereby reducing the impact of these abnormalities (Alzheimer's Society, 2020). The recommended dose of donepezil is 5 mg once a day, increasing to 10 mg per day after 1 month of treatment. Due to the increasing approval and accessibility of this drug worldwide, closer consideration of the available evidence is required to assess the efficacy and safety of this intervention (Alzheimer's Society, 2020).