Snapshot A 69-year-old male is brought by his daughter to the neurologist for the management of his recently diagnosed Alzheimer dementia. The daughter says that at times her father cannot remember events that occured yesterday. There have been instances in which the patient was confused in familiar places, and has been having trouble paying his bills. The daugher believes her father is not hallucinating, and has not noticed any major changes in his personality. The patient was started on donepezil for the patient's mild Alzheimer dementia. Overview A neurodegenerative disorder that is the most common cause of dementia. etiology is unknown; however certain genetic mutations have been described decreased Acetylcholine (ACh) appears to be associated with Alzheimer disease ACh appears to be involved in memory. Choline acetyltransferase activity—involved in ACh synthesis—seems to be decreased in the cerebral cortex, hippocampus, and amygdala in patients with Alzheimer disease. Treatment Acetylcholinesterase inhibitors donepezil, rivastigmine, galantamine to increase ACh concentration can be used for mild-to-moderate Alzheimers toxicity nausea, dizziness, insomnia N-methyl-D-aspartate (NMDA) receptor antagonist memantine can be used for moderate-to-severe Alzheimers believed to decrease intracellular calcium accumulation to aid in the prevention of excitotoxic neuronal damage toxicity commonly is dizziness, headache, and confusion