Alzheimer's patients 'should stay on drugs for longer'

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Thousands of patients with advanced Alzheimer's disease could benefit from drugs, research suggests.

A study in the the New England Journal of Medicine found that patients who stayed on the dementia drug Aricept had a slower decline in their memory.

The drug tends not to be prescribed once sufferers progress beyond moderate symptoms.

Medicines regulator NICE said its guidelines supported continuing treatment where there were benefits.

The patent for the medicine Aricept, which is used to treat Alzheimer's disease, expired recently. Much cheaper versions under the generic name donepezil are already available for about £12 a month.

The researchers say their new evidence could lead to twice as many Alzheimer's sufferers worldwide being given medication.

The trial involved 295 Alzheimer's patients in England and Scotland who had been taking Aricept.

One set were given placebo tablets while another set stayed on Aricept. A third set were given another drug, Ebixa, or memantine, which is usually prescribed only in the later stages of Alzheimer's.

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For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the more severe stages”

Professor Robert Howard Lead researcher

The fourth batch of patients received a combination of both drugs.

The researchers assessed each group for a year, looking at their cognitive scores on factors like memory, and also at how well they coped with everyday tasks such as dressing and eating.

'Robust and compelling' evidence

The drugs were unable to halt the decline of patients, but they slowed it down.

The study's lead author, Professor Robert Howard from King's College London Institute of Psychiatry, said: "For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the more severe stages.

"Patients who continued taking donepezil were about four months ahead in how they were able to remember, communicate and perform daily tasks than those who stopped taking the drugs.

"It means a lot to doctors and carers to see differences like that. These improvements were sustained throughout the year.

"It's fair to say that both drugs have independent, positive effects at this stage of dementia. I'm advising hospital colleagues to continue patients on donepezil, when it's tolerated, and to add in memantine."

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It's not so the NICE guidance that needs to change - but how clinicians interpret it”

Professor Clive Ballard Alzheimer's Society
Controversial restrictions

About 500,000 people in the UK are thought to have Alzheimer's disease - with only about 10% who are in the earlier stages currently on drug treatment.

NHS funding of dementia drugs has been controversial in the past. The National Institute for Health and Clinical Excellence (NICE) set restrictions in 2006, which campaigners tried to overturn in court.

A year ago, revised NICE guidelines accepted that medicines including Aricept were cost-effective and could be prescribed earlier in the course of the disease.

Professor Clive Ballard from the Alzheimer's Society, which part-funded the trial alongside the Medical Research Council, said: "Usual practice has been to discontinue the treatment once patients have declined to a certain stage.

"This trial suggests the default position should be the other way round, because most people are benefiting.

"It's not so much the NICE guidance that needs to change - but how clinicians interpret it."

NICE said its guidelines did not include any specific recommendations on when to discontinue medicines.

Dr Simon Ridley from Alzheimer's Research UK said: "Trials such as this are extremely important for informing decisions about the way medication is prescribed.

"It would be helpful to see longer-term trials to determine exactly how long the benefits seen in this study might last.

"Sadly we still lack a treatment that can stop Alzheimer's disease in its tracks."

STROKE IDENTIFICATION:

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Blood Clots/Stroke - They Now Have a Fourth Indicator, the Tongue

I will continue to forward this every time it comes around!


STROKE: Remember the 1st Three Letters..... S. T. R.


STROKE IDENTIFICATION:


During a BBQ, a woman stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) ...she said she had just tripped over a brick because of her new shoes.


They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Jane went about enjoying herself the rest of the evening.


Jane's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 PM Jane passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Jane would be with us today. Some don't die. They end up in a helpless, hopeless condition instead.


It only takes a minute to read this.


A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.


RECOGNIZING A STROKE
Thank God for the sense to remember the '3' steps, STR. Read and

Learn!


Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.


Now doctors say a bystander can recognize a stroke by asking three simple questions:


S *Ask the individual to SMILE.

T *Ask the person to TALK and SPEAK A

SIMPLE SENTENCE (Coherently)

(I.e. It is sunny out today.)

R *Ask him or her to RAISE BOTH ARMS.


If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.


New Sign of a Stroke -------- Stick out Your Tongue


NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out his tongue. If the tongue is

'crooked', if it goes to one side or the other that is also an indication of a stroke.


A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved.