Diagnosis and Management in Dementia - Chapter 40: Acetylcholinesterase inhibitory agents in plants and their application to dementia: Alzheimer’s disease

Alzheimer’s disease (AD) is the most common type of dementia worldwide. It is a progressive neurodegenerative disorder that gradually destroys the patient’s memory and finally leads to death. The etiology is multifactorial with genetic, environmental, and epigenetic components playing a role. Histopathologically, neuritic plaques, neurofibrillary tangles, and neuronal loss together with cholinergic impairment are the main characteristics of the brain with AD. Despite intensive research, there are no disease-modifying treatments approved for AD. Current drug therapy consists of acetylcholinesterase (AChE) inhibitors to lessen memory shortage due to cholinergic impairment, but these do not alter the course of the disease. Accumulating research of natural products such as alkaloids, flavonoids, saponins, phytoestrogens, and carbohydrates, among others, have shown therapeutic properties. The aim of this review is to provide an overview of natural AChE inhibitors extracted from plants and their therapeutic potential to treat AD.