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Drug Pushes Back Onset of Alzheimer's

USA TODAY - July 19, 2004 People with mild but measurable memory problems who took the drug donepezil, trademarked Aricept, delayed the onset of Alzheimer’s disease by an average of half a year, a study presented Sunday shows. The study indicates that the drug works for just a short time and then stops. Still, the report, presented at the ninth International Conference on Alzheimer’s Disease and Related Disorders in Philadelphia, is the first to find a drug therapy that delays the onset of Alzheimer’s in people at high risk for the disease. The finding doesn’t take researchers any closer to the long-elusive cure for Alzheimer’s, but it’s an important step. ’’This gives us hope that intervention in the early stages will help,’’ says Ronald Petersen, lead investigator of the study. It was paid for by the National Institute on Aging. The 769 people in the study had mild cognitive impairment, a condition that puts people at high risk of developing Alzheimer’s. Roughly 4.8 million Americans have mild cognitive impairment, which usually strikes people over 60. Another 4.5 million people in the USA have Alzheimer’s. Unlike the occasional forgetfulness that affects nearly everyone as they get older, people with mild cognitive impairment have frequent memory lapses. They might ask the same question over and over or forget important appointments. An Alzheimer’s patient suffers from more severe memory lapses and other symptoms, such as confusion. In some cases, research suggests that people with mild cognitive impairment already have the underlying brain damage that is characteristic of Alzheimer’s. The brain compensates for that early injury so people can still function on the job and at home. But some research suggests that it’s only a matter of time before people with this condition progress to Alzheimer’s. Petersen, a neurologist at the Mayo Clinic in Rochester, Minn., and his colleagues gave one-third of the group donepezil, a drug currently approved for Alzheimer’s disease. One-third were given vitamin E, an antioxidant thought to help people with Alzheimer’s by blocking free radicals, molecules that can damage the brain. The rest were given a placebo, or dummy pill. After three years, only donepezil offered an advantage: Among people who ultimately got the disease, the drug pushed back the onset of Alzheimer’s by about six months. Vitamin E had no effect on the disease progression. Delaying the disease, even briefly, offers patients and families the advantage of time: time to plan for the more serious symptoms of the disease, which can make routine tasks such as paying bills impossible, says Bill Thies, a spokesman for the Chicago-based Alzheimer’s Association. Experts stop short of recommending donepezil for everyone with mild cognitive impairment. But people with the condition who are at high risk might want to ask their doctor about taking the drug, which can be prescribed even though it is not approved for this condition, Petersen says. Still, donepezil, and the other drugs of its class, are powerless to stop the Alzheimer’s damage that ultimately destroys the brain. Drugs under development now might be able to prevent or even reverse such damage, says Neil Buckholtz of the National Institute on Aging. But such therapies won’t be available for at least five years. ’’We’re looking for compounds that delay the onset entirely,’’ he says. ’’We don’t have that yet.’’

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