ACHE and Alzheimer disease: However, the efficacy of AChE inhibitor treatment depends on cholinergic integrity as seen in patients with early Alzheimer's disease (Richter et al., 2018) and the use of AChE inhibitors can be limited by the systemic cholinergic adverse effects (Colombres et al., 2004, Doody, 2003, Snape et al., 1999).