Involutional dementias: new perspectives

13 patients with psycho-organic syndrome (POS) and 10 patients with dementia (senile, Alzheimer, multi-infarct) were treated with drugs considered to influence the neuronal turnover of acetylcholine (Phosphatidylcholine, piracetam, S-adenosylmethionine) for 30 days and compared in respect of CSF ACh levels, reaction times to simple visual stimuli (TRS-V) and to simple hearing stimuli (TRS-H) and scores on the Sandoz Clinical Assessment Geriatric (SCAG) rating scale. The POS patients presented higher CSF ACh levels, shorter TRS-V and TRS-H times and lower SCAG scores than the demented patients before treatment. During treatment the CSF ACh values fell in the POS but not in the demented patients. All the other values improved in both groups but more markedly in the POS group. The CSF ACh variations in the latter appear to correlate with the variations in TRS-V and TRS-H times and SCAG scores. The monitoring of CSF ACh would seem to be useful in assessing both the degree of decline in dementia and the possibilities of treatment in individual patients.