Alzheimer’s treatment in late stages of disease does slow progression

 

More than 100,000 people in the UK suffering the “savage” effects of advanced Alzheimer’s disease could benefit from drug treatment to slow its progression.

Scientists have shown for the first time that drugs used to slow the disease in its early stages also work when the condition is advanced, greatly extending the population who could be treated. Advanced Alzheimer’s is marked by the progressive loss of cognitive skills and physical control and leaves individuals stripped of their dignity and personality.

The finding could double the number of patients currently on treatment from 50,000 to over 100,000 in the UK and extend treatment to millions more worldwide. Only one in five of the 500,000 patients with Alzheimer’s in the UK, a third of whom have advanced disease, are currently receiving drug treatment because of a shortage of clinics to diagnose them.

Professor Robert Howard of the Institute of Psychiatry, Kings College, London, who led the study published in the New England Journal of Medicine, said: “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 disease. Patients were better able to remember, understand, communicate and perform daily tasks for at least a year longer than those who stopped taking the drugs.”

 The National Institute for Clinical Health and Excellence (NICE) came under fire when it initially refused to approve donepezil, the commonest drug whose brand name is Aricept, and associated drugs on the ground that they were not cost effective. It said the drugs worked in 40 per cent of those treated. Later it reviewed its decision and recommended the drugs in the early and moderate stages of the disease but not in the late stages.

 Although Its current advice says the drugs should only be withdrawn when doctors consider they are no longer of benefit, the latest findings mean its default position - that the drugs do not work in the late stages of the disease - may now have to be reviewed.

Researchers led by Professor Howard  studied 295 patients with  severe Alzheimers over a year and found continued use of donepezil slowed the deterioration characteristic of the disease by one third, equivalent to four months of improved quality of life.

Those who took a second drug, memantine, in combination, did even better.

Professor Clive Ballard, director of research at the Alzheimer’s Society, which funded the study with the Medical Research Council, said the drug was not a cure but significantly relieved the symptoms: “If I had Alzheimers disease or my relative did I would want them to have [the combination].”

 Donepezil came off patent in February and its cost has  plummeted. It is now priced at around 80 pence a day compared with £2.50 a day for the patented drug, Professor Ballard said. The next stage of the research would be to examine the cost effectiveness of the drug based on the reduced cost.

Professor Nick Fox of the Institute of Neurology, University College, London, said dementia cost Britain £20 billion a year and one third of the population would be affected at some point in their lives.

 “We desperately need therapies that will slow the disease at a stage when we have most to retain. This is a savage disease with a self sustaining momentum of its own.”

The finding comes as a survey shows wide disparities across the country in the resources devoted to the treatment of dementia.

Freedom of Information requests by GP Magazine show spending on dementia services varies more than 20-fold from £802 per head in NHS Barnsley to £38 in NHS Nottinghamshire. NHS Wakefield  paid for 1,875 patients to use its memory services, compared with 117 patients who accessed NHS Wolverhampton's. Both PCTs have a similar prevalence of dementia.

Professor Peter Piot, Director of the London School of Hygiene and Tropical Medicine, and former Under-Secretary General of the United Nations, called  for dementia to become a top health priority for the world  at the opening of the Alzheimer’s Disease International conference.

“'Dementia is one of the largest neglected global health challenges of our generation. What we must learn from the AIDS movement is that by investing now we will save later,” he said.

Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
News
Kim Wilde began gardening in the 1990s when she moved to the countryside
peopleThe singer is leading an appeal for the charity Thrive, which uses the therapy of horticulture
Sport
Alexis Sanchez celebrates scoring a second for Arsenal against Reading
football
Life and Style
health
Voices
An easy-peel potato; Dave Hax has come up with an ingenious method in food preparation
voicesDave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
News
i100
News
Japan's population is projected to fall dramatically in the next 50 years (Wikimedia)
news
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: Project Implementation Executive

    £18000 - £23000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Chiropractic Assistant

    £16500 per annum: Recruitment Genius: A Chiropractic Assistant is needed in a ...

    Recruitment Genius: Digital Account Executive - Midlands

    £18000 - £26000 per annum: Recruitment Genius: They work with major vehicle ma...

    Recruitment Genius: Web Developer

    £28000 - £30000 per annum: Recruitment Genius: This company provides coaching ...

    Day In a Page

    NHS struggling to monitor the safety and efficacy of its services outsourced to private providers

    Who's monitoring the outsourced NHS services?

    A report finds that private firms are not being properly assessed for their quality of care
    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    Zac Goldsmith: 'I'll trigger a by-election over Heathrow'

    The Tory MP said he did not want to stand again unless his party's manifesto ruled out a third runway. But he's doing so. Watch this space
    How do Greek voters feel about Syriza's backtracking on its anti-austerity pledge?

    How do Greeks feel about Syriza?

    Five voters from different backgrounds tell us what they expect from Syriza's charismatic leader Alexis Tsipras
    From Iraq to Libya and Syria: The wars that come back to haunt us

    The wars that come back to haunt us

    David Cameron should not escape blame for his role in conflicts that are still raging, argues Patrick Cockburn
    Sam Baker and Lauren Laverne: Too busy to surf? Head to The Pool

    Too busy to surf? Head to The Pool

    A new website is trying to declutter the internet to help busy women. Holly Williams meets the founders
    Heston Blumenthal to cook up a spice odyssey for British astronaut manning the International Space Station

    UK's Major Tum to blast off on a spice odyssey

    Nothing but the best for British astronaut as chef Heston Blumenthal cooks up his rations
    John Harrison's 'longitude' clock sets new record - 300 years on

    ‘Longitude’ clock sets new record - 300 years on

    Greenwich horologists celebrate as it keeps to within a second of real time over a 100-day test
    Fears in the US of being outgunned in the vital propaganda wars by Russia, China - and even Isis - have prompted a rethink on overseas broadcasters

    Let the propaganda wars begin - again

    'Accurate, objective, comprehensive': that was Voice of America's creed, but now its masters want it to promote US policy, reports Rupert Cornwell
    Why Japan's incredible long-distance runners will never win the London Marathon

    Japan's incredible long-distance runners

    Every year, Japanese long-distance runners post some of the world's fastest times – yet, come next weekend, not a single elite competitor from the country will be at the London Marathon
    Why does Tom Drury remain the greatest writer you've never heard of?

    Tom Drury: The quiet American

    His debut was considered one of the finest novels of the past 50 years, and he is every bit the equal of his contemporaries, Jonathan Franzen, Dave Eggers and David Foster Wallace
    You should judge a person by how they peel a potato

    You should judge a person by how they peel a potato

    Dave Hax's domestic tips are reminiscent of George Orwell's tea routine. The world might need revolution, but we like to sweat the small stuff, says DJ Taylor
    Beige is back: The drab car colours of the 1970s are proving popular again

    Beige to the future

    Flares and flounce are back on catwalks but a revival in ’70s car paintjobs was a stack-heeled step too far – until now
    Bill Granger recipes: Our chef's dishes highlight the delicate essence of fresh cheeses

    Bill Granger cooks with fresh cheeses

    More delicate on the palate, milder, fresh cheeses can also be kinder to the waistline
    Aston Villa vs Liverpool: 'This FA Cup run has been wonderful,' says veteran Shay Given

    Shay Given: 'This FA Cup run has been wonderful'

    The Villa keeper has been overlooked for a long time and has unhappy memories of the national stadium – but he is savouring his chance to play at Wembley
    Timeless drama of Championship race in league of its own - Michael Calvin

    Michael Calvin's Last Word

    Timeless drama of Championship race in league of its own