A new approach to treating Alzheimer's disease.

It is rational to try to normalize changes that correlate with the severity of the clinical disabilities in Alzheimer's disease (AD) rather than focusing on other of the many abnormalities in end-stage AD brain that relate only theoretically to the clinical manifestations. The neurobiological measure that correlates most closely to the degree of cognitive deterioration is reduction in cerebral metabolic rate. An attempt to treat this abnormality in AD patients is described; it is based, in part, on metabolic control theory. Encouraging results of a preliminary double-blind clinical trial do not allow confident conclusions but do support the need for more intensive examination of this approach to AD treatment.