Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by pathological features such as tau protein aggregation and hyperphosphorylation, chronic neuroinflammation, and cholinergic dysfunction mediated by acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). Here, BCHE is linked to early-onset autosomal dominant Alzheimer disease.