Donepezil treatment may associated with slow cognitive decline effects for a limited period of time in Alzheimer’s disease (AD). We report a 78 year old highly educated man of mild to moderate probable AD treated by a combination therapy of donepezil, nicergoline, nimodipine and TCM herbal therapy. His cognitive function and global status improved slowly over 2.5 years, from 21 scores on MMSE at first visit to 28 scores on MMSE at final visit. The diagnosis of AD was made mainly based on his complaint of memory loss, hidden onset, and gradually increased medical history, objective evidence of neuropsychological tests demonstrating cognitive impairment and hippocampal atrophy on MRI. His mild dementia slowly showed improvement to normal cognition over a period of 2.5 years. Further studies are needed to define the role of combination therapy in treating Alzheimer’s disease.