Which cholinergic agent is indicated for the treatment of Alzheimer’s disease?

The indicated cholinergic agent for the treatment of Alzheimer’s disease is donepezil. This medication belongs to a class of drugs known as acetylcholinesterase inhibitors. Donepezil works by increasing the concentration of acetylcholine in the synaptic cleft by inhibiting the enzyme that breaks it down. This is particularly beneficial in Alzheimer’s disease, where there is a significant depletion of acetylcholine due to neurodegeneration.

In patients with Alzheimer's disease, the cholinergic system is significantly affected, particularly in areas of the brain associated with memory and cognition. By enhancing cholinergic activity, donepezil can help improve cognitive function and slow the progression of symptoms in some patients. This mechanism of action explains why donepezil is specifically indicated for managing Alzheimer's, making it a key therapeutic option in this condition.

The other options provided do not serve this purpose: pilocarpine is primarily used to treat glaucoma and xerostomia, atropine is an anticholinergic used for various indications such as bradycardia, and scopolamine is used primarily for motion sickness and to decrease secretions. None of these address the underlying cholinergic deficit seen in Alzheimer's disease.