6p-a-day drug saves dementia sufferers from going into care

A CHEAP drug could save thousands of dementia patients from going into care, a study shows.

Researchers at University College London found that those taking donepezil were twice as likely to still be in their home 12 months later.

Costing just £21.59 a year – 6p a day – donepezil is used to tackle mild to moderate Alzheimer’s. Most doctors withdraw it in advanced stages of the disease because until now there had been little evidence that it continued to work.

But the UCL research, published in the journal Lancet Neurology, shows that if patients are kept on the drug they are far more likely to avoid being placed in a nursing home.

Donepezil, which boosts the levels of communication chemicals within the brain, slows the decline of memory as well as the ability to carry out everyday tasks.

Among patients with advanced dementia, the effect is only modest. Yet the research shows that even a slight brake on cognitive decline is enough to significantly delay admission to a nursing home.

Robert Howard, who led the study, said: ‘Our new results show that these benefits translate into a delay in becoming dependent on residential care, an event that many people dread.

‘We are all impatient for the advent of true disease-modifying drugs that can slow or halt the Alzheimer process, but donepezil is available right now and at modest cost.’

His results, from tests carried out on 295 people with moderate to severe Alzheimer’s, found that in the first 12 months of donepezil being withdrawn, 37 per cent of patients were moved into a home. This was true of only 20 per cent of those who carried on taking the drug.

Donepezil, which is also sold under the brand-name Aricept by drugs giant Pfizer, has plummeted in price since the patent expired in 2010.

An estimated 58,000 patients took it in Britain in 2012 but Professor Howard said he expected many more doctors to prescribe it on the back of his results.

He said: ‘People will look at our trial and it will make them think these drugs have more to offer in severe Alzheimer’s disease patients than was previously thought.

‘If a family member had Alzheimer’s disease I would want to see that they were on a drug like donepezil.’

The Alzheimer’s Society calculated that if all patients who were diagnosed with severe forms of the disease were given the drug, the numbers admitted to care homes would be reduced by 26,000 a year.

The annual cost of residential care for people with dementia ranges is at least £30,000. Some people who take the drug suffer mild side effects including nausea and digestive problems. Very occasionally, patients experience more severe problems, including altered heart rhythm and fainting.

No drugs currently on the market slow the progress of dementia itself, although some experimental products have shown promise.

Donepezil has a European medicine licence for mild to moderate Alzheimer’s but it is for individual doctors to decide whether to give it in the later stages of the disease.

NHS rationing watchdog Nice has also approved the drug, but advises doctors: ‘Treatment should be continued only when it is considered to be having a worthwhile effect on cognitive, global, functional or behavioural symptoms.’

Doug Brown, research director at the Alzheimer’s Society, which partly funded the study, said: ‘With no new treatments for Alzheimer’s disease in over a decade, it is absolutely crucial that we make the most of the drugs we have available.

‘Residential care can be the best option for someone whose care needs are complex, but it is important that we continue to find better ways to support people with dementia to remain in their own homes for longer. These robust findings are of real significance to people with dementia and their families.

‘We urge clinicians to consider the implications of this research and adjust their prescribing patterns accordingly.’

It is estimated that 527,000 Britons have Alzheimer’s, which is the most common form of dementia.

Elizabeth Coulthard, a Bristol University dementia expert, said: ‘It is heartening to think donepezil might delay entry to a nursing home.’

But Dr Mark Dallas of the University of Reading, warned the study showed ‘we are still behind the game’.

He added: ‘We desperately need to conduct clinical trials in patients’ presymptoms to determine the brain changes that lead to Alzheimer’s.

‘Only then will we have a chance to target the disease process itself and provide medicines that can delay the progress of Alzheimer’s.’

‘Available right now’