Commonly used dementia drugs can help more patients with Alzheimer's
The dementia drug donepezil (Aricept), already widely used to treat mild to moderate Alzheimer's disease, can also help in moderate to severe patients, according to a report funded by the UK Medical Research Council (MRC) and the Alzheimer's Society. The study suggests that extending treatment to this group could help treat twice as many sufferers worldwide. Encouragingly, the drug has greater positive benefits for patients more severely affected than for those in the earlier stages of dementia.
It is estimated that 18 million people worldwide suffer from Alzheimer's disease, which is the most common cause of dementia. According to the World Health Organization, of the 35 million people currently living with dementia globally, 58% live in low- and middle-income countries and by 2050 this figure is projected to reach 71% of the total.
The multi-centre UK study, led by Professor Robert Howard at King's College London, is the first trial to demonstrate the value of continued drug intervention for those patients with moderate to severe Alzheimer's disease who have deteriorated beyond the point where donepezil is currently recommended.
The study, to be published in the New England Journal of Medicine, looked at two drugs: donepezil and memantine. Donepezil is the most commonly prescribed of the dementia drugs and is recommended for patients at the earliest stages of Alzheimer's disease. Doctors are currently advised to stop prescribing donepezil when the disease progresses to become moderate to severe and until now there has been no clear evidence that continuing treatment is of benefit to patients.
Over the course of the trial, patients who continued to take donepezil showed considerably less decline in cognition memory, orientation, language function and function (retained ability to carry out simple daily tasks and self-care) than those taking a placebo drug. The benefits seen with continued treatment were clinically important and were greater than those previously seen in patients with less severe Alzheimer's disease. Whilst the effect was slightly smaller, starting memantine treatment also resulted in significantly better cognitive and functional abilities compared with those taking a placebo.
Professor Robert Howard, lead author from the Institute of Psychiatry at King's says: "As patients progress to more severe forms of Alzheimer's disease, clinicians are faced with a difficult decision as to whether to continue or not with dementia drugs and, until now, there has been little evidence to guide that decision. For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the later, more severe stages of the disease. We observed that patients who continued taking donepezil were better able to remember, understand, communicate and perform daily tasks for at least a year longer than those who stopped taking the drugs. These improvements were noticeable to patients, their caregivers and doctors. Both donepezil and memantine will soon be off patent and available in very cheap generic preparations. These findings will greatly increase the numbers of patients in the developed and developing world that we are able to treat."
Professor Nick Fox, MRC Senior Clinical Fellow at the Institute of Neurology, University College London, says: "The number of people with Alzheimer's disease and other forms of dementia is reaching critical levels. It has never been more important to invest in research which will enable doctors to make informed decisions based on the best evidence possible when deciding what treatments to give patients. The MRC has an ongoing commitment to the development of effective, safe treatments that will improve the quality of life for people with Alzheimer's disease and their care givers."
Professor Clive Ballard, Director of Research at Alzheimer's Society, says: "Thanks to the Alzheimer's drug donepezil, tens of thousands of people in the early to moderate stages of the condition are able to recognise their family for longer, play with their grandchildren and make vital plans for the future. This major new trial now shows that there could also be significant benefits on continuing the treatment into the later stages too. There are 750,000 people with dementia in the UK yet currently prescription levels of Alzheimer's drugs are still low. If this is to change we have to improve the shocking diagnosis rates and ensure everyone is given the opportunity to try treatments."
More information: Howard et al 'Donepezil and Memantine for Moderate-to-Severe Alzheimer's Disease' is published in New England Journal of Medicine.
WHO information on dementia epidemic in Asia: www.who.int/bullet… 1-020311/en/
Journal reference: New England Journal of Medicine
Provided by King's College London
- Research contributes to revised decision on availability of Alzheimer's drugs Jan 18, 2011 | not rated yet | 0
- Depression may increase risk of Alzheimer's disease in people with memory problems Jun 15, 2009 | not rated yet | 0
- Risk of abnormally slow heart rate twice as high in those taking drugs to slow Alzheimer's Oct 01, 2009 | not rated yet | 0
- Antipsychotic drugs double risk of death among Alzheimer's patients Jan 09, 2009 | not rated yet | 0
- Evidence lacking for efficacy of memantine in treating mild Alzheimer's disease Apr 11, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Indeterminism in Classical Physics
5 hours ago I was reading the Roger Penrose book Emperor's New Mind and he was explaining the determinism in Newtonian mechanics. He says that if we consider...
Current in two wires
5 hours ago Wire A and B, which have the same cross-sectional area are connected in series. There is a p.d. V across the whole wire. Suppose the two wires...
understanding the dipole model for Rayleigh scattering
7 hours ago Hello. I am currently studying scattering theory in detail for my BSc thesis, and I'm starting with Rayleigh scattering. I'm following Scattering...
question on coriolis effect with drag force
13 hours ago I really need help with this question. A small floating object initially moves with velocity v on the surface of a liquid at latitude λ. The...
Question of reflection and transmission of TEM wave in normal incidenc
19 hours ago Suppose TEM wave in +z normal to a boundary on xy plane at z=0. We know *E* & *H* are tangential to the boundary. Let ##\vec E_i=\hat x E##, be the...
the rudyak-krasnolutski effective potencial
20 hours ago Hi ... anyone now how to calculate or the formula of the rudyak-krasnolutski EFFECTIVE potencial ? the effective potencial includes the angular...
- More from Physics Forums - Classical Physics
More news stories
In the search for medication against Alzheimer's disease, scientists have focused – among other factors – on drugs that can break down Amyloid beta (A-beta). After all, it is the accumulation of A-beta that causes the ...
Alzheimer's disease & dementia 3 hours ago | not rated yet | 0
(Medical Xpress)—The way Alzheimer's disease is portrayed by advocacy groups and the media is having undue influence on the euthanasia debate, according to a Deakin University nursing ethics professor.
Alzheimer's disease & dementia 4 hours ago | not rated yet | 0
Cinnamon: Can the red-brown spice with the unmistakable fragrance and variety of uses offer an important benefit? The common baking spice might hold the key to delaying the onset of –– or warding off ...
Alzheimer's disease & dementia 20 hours ago | 5 / 5 (5) | 0 |
An anti-cancer drug reverses memory deficits in an Alzheimer's disease mouse model, University of Pittsburgh Graduate School of Public Health researchers confirm in the journal Science.
Alzheimer's disease & dementia 21 hours ago | not rated yet | 0 |
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
Alzheimer's disease & dementia 21 hours ago | 3 / 5 (2) | 3 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
15 minutes ago | not rated yet | 0 |
The news about youth and diabetes keeps getting worse. The latest data from the national TODAY diabetes study shows that children who develop Type 2 diabetes are at high risk to develop heart, kidney and eye problems faster ...
13 minutes ago | not rated yet | 0
In Parkinson's disease, the protein "alpha-synuclein" aggregates and accumulates within neurons. Specific areas of the brain become progressively affected as the disease develops and advances. The mechanism underlying this ...
12 minutes ago | not rated yet | 0
After studying noise in one French Quarter neighborhood of New Orleans to determine whether or not noise levels exceeded municipal ordinances, Annette Hurley, PhD, Assistant Professor of Audiology at LSU Health Sciences Center ...
29 seconds ago | not rated yet | 0
Transcatheter aortic valve implantation (TAVI) is effective and safe in Asian patients, according to early experience based on first results from a multicentre Asian registry reported at EuroPCR 2013.
10 minutes ago | not rated yet | 0
Young children who missed more than half of recommended well-child visits had up to twice the risk of hospitalization compared to children who attended most of their visits, according to a study published today in the American Jo ...
14 minutes ago | not rated yet | 0