Clinicians whose practice includes elderly patients need a short, reliable instrument to detect the presence of intellectual impairment and to determine the degree. A 10-item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated. The standardization and validation procedure included administering the test to 997 elderly persons residing in the community, to 141 elderly persons referred for psychiatric and other health and social problems to a multipurpose clinic, and to 102 elderly persons living in institutions such as nursing homes, homes for the aged, or state mental hospitals. It was found that educational level and race had to be taken into account in scoring individual performance. On the basis of the large community population, standards of performance were established for: 1) intact mental functioning, 2) borderline or mild organic impairment, 3) definite but moderate organic impairment, and 4) severe organic impairment. In the 141 clinic patients, the SPMSQ scores were correlated with the clinical diagnoses. There was a high level of agreement between the clinical diagnosis of organic brain syndrome and the SPMSQ scores that indicated moderate or severe organic impairment.

Vitamin E had no benefit in patients with mild cognitive impairment. Although donepezil therapy was associated with a lower rate of progression to Alzheimer's disease during the first 12 months of treatment, the rate of progression to Alzheimer's disease after three years was not lower among patients treated with donepezil than among those given placebo.

In patients with moderately severe impairment from Alzheimer's disease, treatment with selegiline or alpha-tocopherol slows the progression of disease.

ALZHEIMER DISEASE (AD) IS among the most important health problems of elderly persons, affecting more than 4 million people in the United States. In the last decade, cholinesterase inhibitors have been widely used to alleviate symptoms of cognitive dysfunction in AD. The use of anti-inflammatory drugs is among the strategies under active investigation for the development of effective disease-modifying treatment for AD. This approach is supported by a wealth of laboratory evidence that inflammatory mechanisms contribute to neuronal damage in AD. 1 Furthermore, many epidemiological studies suggest that antiinflammatory drugs have a protective effect, reducing the incidence of AD. 2 Results of small pilot clinical trials of nonsteroidal anti-inflammatory drug Author Affiliations and Participating members of this Alzheimer's Disease Cooperative Study are listed at the end of this article.

A LZHEIMER DISEASE (AD) AFfects more than 4 million Americans and is one of the most frequent obstacles to healthy aging in this country. Women appear to be at higher risk for developing AD, only in part due to increased longevity.1 Because women with AD also live longer than men with AD, there are approximately twice as many women as men in the population with this disorder. It has been suggested that the abrupt decline of estrogen production in postmenopausal women may be associated with a vulnerability of women to develop AD. Men, in contrast, have an intrinsic supply of estro-