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There were no cures or miracle breakthroughs reported at the big Alzheimer's conference in Philadelphia last week, but there were glimmers of hope for the families of the 4.5 million Americans who suffer from the disease.

The best news was that scientists have found — for the first time — a drug that delays the onset of Alzheimer's in patients with mild cognitive impairment. These are people who have memory problems (slips of the tongue, brief memory lapses) but can still balance a checkbook or prepare a meal. The drug they were given, Pfizer's Aricept, is widely prescribed for patients who already have Alzheimer's. In a trial conducted by researchers at the Mayo Clinic, nearly 800 patients were randomly assigned Aricept, a placebo or vitamin E for three years. In checkups after six, 12 and 18 months, people in the group taking Aricept showed fewer signs of dementia than the people taking placebos or vitamin E, although by the end of the three years, the Aricept group had caught up.

Still, lead researcher Dr. Ronald Petersen was encouraged, seeing this as a first step in a process by which scientists "could start to nudge back the onset of the disease by years," possibly even postponing it altogether. Already, many doctors have begun prescribing Aricept for patients at high risk of developing Alzheimer's. If you believe you or a loved one may be a candidate, ask your doctor.

Many were surprised that vitamin E did no better than a placebo in the Mayo experiment. Vitamin E is a potent antioxidant, and previous studies had shown that taking megadoses of the vitamin could keep Alzheimer's patients out of a nursing home a little longer. Perhaps what's called for is a mix of drugs and vitamins.

If so, the answer may come soon. The U.S. spends more than $1 billion a year on dementia drugs, and new ones are being developed every day. Researchers at Eli Lilly reported progress in Philadelphia on a compound that targets the sticky plaques in the brain that are the root cause of Alzheimer's. Other people, like Nancy Reagan, are pinning their hopes for a cure on stem cells — although experts are worried that in the wake of Ronald Reagan's death from Alzheimer's, those prospects may have been oversold. There are no miracle cures on the horizon, but there is reason for hope.

• Sanjay Gupta