Trial of Carvedilol in Alzheimer's Disease

Inclusion Criteria:

1. Diagnosis of AD by NINCDS/ADRDA criteria (47)
2. Mini-Mental State Exam (MMSE) 16-26. This range corresponds roughly to "mild" AD as rated by CDR below, and provides a rapid test for efficient screening of potential participants.
3. Clinical Dementia Rating (CDR) < 1 (mild dementia). This corresponds with "early" AD (see D.2.5 above). Participants will be eligible if they have AD diagnosis and CDR of 0.5 or 1.0. The category of CDR 0.5 AD is particularly important to include as these participants are in the earliest stage that can be diagnosed as dementia (as opposed to mild cognitive impairment) and thus are in the "earliest" clinical stage of AD.
4. Patients will be allowed to remain on current FDA-approved Alzheimer's treatments including cholinesterase inhibitors and memantine, so long as the dose has been stable for >= 3 months. These medications lack any notable effects on amyloid synthesis or metabolism and thus there is no reason to exclude them. The rationale behind requiring a stable dose is so that change in the trial can be attributed to the study intervention rather than recent changes of other medications affecting cognition.
5. Patients will be allowed to remain on antidepressant and antipsychotics medications so long as the dose has been stable for >= 3 months. The rationale is the same as item 5.
6. Knowledgeable informant available for all study visits. This is standard practice in AD research because many standard instruments (in this trial including CDR, NPI, ADCS-ADL) require a knowledgeable informant.

Exclusion criteria

1. Evidence of non-AD dementias including Huntington's disease, Parkinson's disease, or frontotemporal dementia.
2. Current DSM-IV Axis I diagnoses other than dementia, including major depression, bipolar disorder, schizophrenia, anxiety disorders, alcohol abuse, or other substance abuse. These diagnoses would merit their own treatment plans and changes in these conditions could significantly affect cognitive and functional outcomes, confounding our efforts to study the efficacy of the study intervention.
3. Any clinically significant medical condition that could interfere with the subject's ability to safely participate in the study or to be followed.
4. Current use of Beta-blocking agents
5. Contraindications to use of Beta-blocking agents, to be determined in consultation with the patient's primary care physician or (if appropriate) cardiologist.
6. Clinically significant hepatic or renal insufficiency.