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 Although Its current advice says the drugs should only be withdrawn when doctors consider they are no longer of benefit, the latest findings mean its default position - that the drugs do not work in the late stages of the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

News
people Emma Watson addresses celebrity nude photo leak
News
Katie Hopkins appearing on 'This Morning' after she purposefully put on 4 stone.
peopleKatie Hopkins breaks down in tears over weight gain challenge
News
Boris Johnson may be manoeuvring to succeed David Cameron
i100
News
peopleHis band Survivor was due to resume touring this month
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
News
people'It can last and it's terrifying'
News
In this photo illustration a school student eats a hamburger as part of his lunch which was brought from a fast food shop near his school, on October 5, 2005 in London, England. The British government has announced plans to remove junk food from school lunches. From September 2006, food that is high in fat, sugar or salt will be banned from meals and removed from vending machines in schools across England. The move comes in response to a campaign by celebrity TV chef Jamie Oliver to improve school meals.
science
Arts and Entertainment
tv
Life and Style
fashionModel of the moment shoots for first time with catwalk veteran
Life and Style
fashionPart of 'best-selling' Demeter scent range
News
i100
Sport
Tom Cleverley
footballLoan move comes 17 hours after close of transfer window
Sport
Alexis Sanchez, Radamel Falcao, Diego Costa and Mario Balotelli
footballRadamel Falcao and Diego Costa head record £835m influx
Life and Style
fashionAngelina Jolie's wedding dressed revealed
News
i100
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

    Science Teacher Urgently required for October start

    £6720 - £33600 per annum: Randstad Education Nottingham: We are currently recr...

    ICT Teacher

    £120 - £130 per day: Randstad Education Group: We are looking for an outstandi...

    Art & Design Teacher

    £120 - £130 per day: Randstad Education Group: We are looking for an outstandi...

    Assistant Management Accountant -S/West London - £30k - £35k

    £30000 - £35000 per annum: Ashdown Group: We are working with an exciting orga...

    Day In a Page

    'I’ll tell you what I would not serve - lamb and potatoes': US ambassador hits out at stodgy British food served at diplomatic dinners

    'I’ll tell you what I would not serve - lamb and potatoes'

    US ambassador hits out at stodgy British food
    Radio Times female powerlist: A 'revolution' in TV gender roles

    A 'revolution' in TV gender roles

    Inside the Radio Times female powerlist
    Endgame: James Frey's literary treasure hunt

    James Frey's literary treasure hunt

    Riddling trilogy could net you $3m
    Fitbit: Because the tingle feels so good

    Fitbit: Because the tingle feels so good

    What David Sedaris learnt about the world from his fitness tracker
    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Saudis risk new Muslim division with proposal to move Mohamed’s tomb

    Second-holiest site in Islam attracts millions of pilgrims each year
    Alexander Fury: The designer names to look for at fashion week this season

    The big names to look for this fashion week

    This week, designers begin to show their spring 2015 collections in New York
    Will Self: 'I like Orwell's writing as much as the next talented mediocrity'

    'I like Orwell's writing as much as the next talented mediocrity'

    Will Self takes aim at Orwell's rules for writing plain English
    Meet Afghanistan's middle-class paint-ballers

    Meet Afghanistan's middle-class paint-ballers

    Toy guns proving a popular diversion in a country flooded with the real thing
    Al Pacino wows Venice

    Al Pacino wows Venice

    Ham among the brilliance as actor premieres two films at festival
    Neil Lawson Baker interview: ‘I’ve gained so much from art. It’s only right to give something back’.

    Neil Lawson Baker interview

    ‘I’ve gained so much from art. It’s only right to give something back’.
    The other Mugabe who is lining up for the Zimbabwean presidency

    The other Mugabe who is lining up for the Zimbabwean presidency

    Wife of President Robert Mugabe appears to have her sights set on succeeding her husband
    The model of a gadget launch: Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed

    The model for a gadget launch

    Cultivate an atmosphere of mystery and excitement to sell stuff people didn't realise they needed
    Alice Roberts: She's done pretty well, for a boffin without a beard

    She's done pretty well, for a boffin without a beard

    Alice Roberts talks about her new book on evolution - and why her early TV work drew flak from (mostly male) colleagues
    Get well soon, Joan Rivers - an inspiration, whether she likes it or not

    Get well soon, Joan Rivers

    She is awful. But she's also wonderful, not in spite of but because of the fact she's forever saying appalling things, argues Ellen E Jones
    Doctor Who Into the Dalek review: A classic sci-fi adventure with all the spectacle of a blockbuster

    A fresh take on an old foe

    Doctor Who Into the Dalek more than compensated for last week's nonsensical offering