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.

Patients with MCI had a predominant memory impairment with relative sparing of other cognitive domains and were intermediate between clinically normal individuals and patients with AD on cognitive and functional ratings. These results demonstrate the successful implementation of operational criteria for this unique group of at-risk patients in a multicenter clinical trial.

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-