. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol. 2007 Jun;6(6):501-12. PubMed.

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  1. This paper "officially" completes the general failure of cholinesterase inhibitors in MCI. Two possible explanations emerge.

    1. The MCI construct is not clinically valid and needs to be re-evaluated before other trials are started.
    2. MCI is valid as a construct, but inhibitors are fundamentally a bad idea for such cases, because they disrupt compensatory mechanisms that are in force during this period of the dementing process.

    For the interested reader, a meta-analysis of inhibitors in MCI is already published.

    References:

    . Cholinesterase inhibitors in mild cognitive impairment: a meta-analysis of randomized controlled trials. Neurol Neurochir Pol. 2007 Jan-Feb;41(1):13-21. PubMed.