Commonly used dementia drugs can help more patients with Alzheimer's

March 7, 2012

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 , which is the most common cause of . According to the , 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 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 , looked at two drugs: donepezil and memantine. Donepezil is the most commonly prescribed of the 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 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 . 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."

Explore further: Evidence lacking for efficacy of memantine in treating mild Alzheimer's disease

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/bulletin/volumes/89/3/11-020311/en/

Related Stories

Evidence lacking for efficacy of memantine in treating mild Alzheimer's disease

April 11, 2011
An analysis of studies involving the drug memantine finds a lack of evidence for benefit when the drug is used to treat patients with mild Alzheimer disease, according to a report posted online today that will appear in the ...

Memantine drug ineffective against Alzheimer's in Down's syndrome patients

January 11, 2012
(Medical Xpress) -- Memantine, a drug used to treat patients with Alzheimer’s disease, is ineffective for people with Down’s syndrome aged 40 and over, according to a study led by researchers at King’s and ...

Recommended for you

Dementia with Lewy bodies: Unique genetic profile identified

December 15, 2017
Dementia with Lewy bodies has a unique genetic profile, distinct from those of Alzheimer's disease or Parkinson's disease, according to the first large-scale genetic study of this common type of dementia.

Major cause of dementia discovered

December 11, 2017
An international team of scientists have confirmed the discovery of a major cause of dementia, with important implications for possible treatment and diagnosis.

Canola oil linked to worsened memory and learning ability in Alzheimer's

December 7, 2017
Canola oil is one of the most widely consumed vegetable oils in the world, yet surprisingly little is known about its effects on health. Now, a new study published online December 7 in the journal Scientific Reports by researchers ...

Genetics study suggests that education reduces risk of Alzheimer's disease

December 7, 2017
The theory that education protects against Alzheimer's disease has been given further weight by new research from the University of Cambridge, funded by the European Union. The study is published today in the BMJ.

Healthy mitochondria could stop Alzheimer's

December 6, 2017
Alzheimer's disease is the most common form of dementia and neurodegeneration worldwide. A major hallmark of the disease is the accumulation of toxic plaques in the brain, formed by the abnormal aggregation of a protein called ...

Alzheimer's damage in mice reduced with compound that targets APOE gene

December 6, 2017
People who carry the APOE4 genetic variant face a substantial risk for developing Alzheimer's disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.