Alzheimer’s going undiagnosed: report
Researchers say less than half of affected patients identified by doctors
Doctors need to focus more on existing prescription drugs used to treat symptoms of Alzheimer’s disease, rather than just the next generation of medicines aimed at combating the illness, leading researchers in the field say.
Dr. Gary Small, a professor of psychiatry and biobehavioural sciences at UCLA’s school of medicine, and Dr. Rachelle Doody, chair of Alzheimer’s research at the college of medicine at Baylor in Texas, released a report Sunday showing doctors are falling short in their use of currently available medicines that are proven to have “important positive clinical impact” on all stages of Alzheimer’s disease.
Their report, issued during the kickoff of the Alzheimer’s Association International Conference this week in Toronto — which Doody and Small are both in town for — also notes that less than 50 per cent of affected patients are currently diagnosed with Alzheimer’s.
Doody and Small noted that less than 25 per cent of diagnosed patients are receiving treatment, and if prescribed medicines, less than half of those with Alzheimer’s are remaining on therapy after four years.
“It is unfortunate that only a minority of primary-care doctors believe they have received sufficient training to diagnose the disease,” Small says in a statement.
He added: “We see patients regularly for whom the diagnosis of Alzheimer’s was missed. Unfortunately, the result is people with the disease are not getting treated.”
Approved drugs that have been around since the1990s that affect the cholinergic system — which involves a chemical made by brain cells that is essential for memory, behaviour and thinking — are the only drugs “shown to have a positive impact on all stages of Alzheimer’s disease,” the researchers note.
But there’s a misconception among some doctors and patients that these drugs don’t provide much benefit, Doody says.
It’s important to treat patients im-
“You see experts from the U.S. expressing concern that drugs we have already are not being used.” DR. SHARON COHEN MEDICAL DIRECTOR, TORONTO MEMORY PROGRAM
mediately after diagnosis to slow down progression of the illness, she adds.
Dr. Sharon Cohen, medical director of an Alzheimer’s program called Toronto Memory Program, a medical facility specializing in the diagnosis and treatment of Alzheimer’s, echoes the findings by Doody and Small.
“The disease is a progressive disease and both physicians prescribing and treating patients, (as well as) patients and their families haven’t un- derstood clearly enough that we’re treating symptoms in a progressive disease, and treating symptoms is still worthwhile,” Cohen said in an interview at the conference Sunday.
Cohen says the next generation of Alzheimer’s treatments being tested, disease modifying medicines, will slow progression and get at the underlying brain changes, not just symptoms of Alzheimer’s, and hopefully either stabilize or perhaps even one day reverse or cure the disease.
“So that goal is very valid, but we’re not there yet,” she says. Right now there are approved drugs available to treat symptoms, but they have been “trivialized” unfortunately for many reasons, and it’s not just across Canada, Cohen argues.
“You see experts from the U.S. expressing concern that drugs we have already are not being used. And I think the general public gets the feeling there’s nothing for Alzheimer’s disease,” Cohen says.