ACHE and early-onset autosomal dominant Alzheimer disease: One of these pathways is the acetylcholinesterase (AChE) pathway, which results in a progressive loss of neuronal communication.4 In Alzheimer's disease progression, the decline in acetylcholine levels due to the degeneration of cholinergic neurons contributes to cognitive impairment.5 Reduced acetylcholine availability disrupts synaptic transmission, exacerbating memory deficits and cognitive decline over time.6 As a result of reduced acetylcholine (ACh) activity in the hippocampus, memory deficits are believed to be caused by the degeneration of cholinergic neurons.