Levodopa in the treatment of (pre) senile dementia

A progressive decrease of dopamine and related enzyme activities and a decline in the dopaminergic receptor functions in the striatum and limbic system controlling behavior have been observed in senescent brain. These changes provide a neurochemical basis for some behavioral and mental disturbances of the aged and suggest the possibility of a substitution therapy of neurotransmitter deficiency of senile and presenile dementia. Previous reports on the effects of levodopa treatment of dementia in parkinsonism and aging have given conflicting results. A controlled double-blind study of 6 months' administration of levodopa plus decarboxylase inhibitor given at oral doses of 250 mg daily versus placebo in twelve patients aged 54--60 years showing initial signs of organic dementia was performed. Clinical rating of twelve parameters of organic brain syndrome and psychometric studies using three subtests of the HAWIE (digit span, coding B test and block design) indicate improvement in the overall scores of organic brain syndrome and in particular in the visuospatial functions, visual memory, and visual-motor coordination. In general, improvement increased with the duration of levodopa treatment. These preliminary data suggest some beneficial effect of levodopa treatment in early stages of presenile dementia and thus open new therapeutic aspects in neurogerontology.