NORMAN RELKIN, M.D.
New York, April 7, 2004
The writer is director of the Weill Cornell Memory
Disorder Program.
To the Editor:
My mother, when she was 89 and rapidly losing her
memory, began taking Aricept and became so agitated
that she walked seven and a half miles to try to reach
my home, in the wrong direction on a dangerous road
(front page, April 7). Her doctor suggested Reminyl,
which resulted in paranoia.
Families need to balance their desire for improvement
in this wrenching disease (and the drum-beating of
the pharmaceutical companies) with the potential to
overmedicate the fragile elderly.
It's not an easy decision because watching the effect
of Alzheimer's is so sad.
LENORE H. FORSTED
Wynnewood, Pa., April 7, 2004
To the Editor:
In your article on medications for Alzheimer's disease
(front page, April 7), the moderator of a panel
discussion on the disease is quoted as saying primary-care
doctors have to look into their souls and do what
they think is right regarding the use of drugs for
which the studies are equivocal. His comment should
instead be directed to his fellow panelists, many
of whom are supported by drug company money and
are the source of this inadequate research.
If a fraction of the billions made on these drugs
could be directed toward doing conclusive research,
untarnished by drug company demands and a publication
bias toward positive results, we might be able to
make some sense of the quandary.
These medications are not benign in the elderly,
and their cost is not only financial.
DAVID KAUFMAN, M.D.
Northampton, Mass., April 7, 2004
To the Editor:
Alzheimer's disease (front page, April 7) is notable
for its biological as well as clinical heterogeneity.
Unfortunately, we do not yet know how to pick out
in advance who will and who will not respond to
treatments.
After two years, a patient of mine recently regained
the ability to dial a telephone and look up a phone
number. His call to his daughter delighted him,
his wife and his daughter. Although no one expects
him to go back to reading the law review, he and
his family feel that his treatment is worth it.
We continue to treat heart disease and stroke, even
though these conditions are still major causes of
death and disability in our society.
We need to accumulate more knowledge while we continue
to do the best we can for our patients with what
we already know.
JOHN P. BLASS, M.D.
New York, April 7, 2004
The writer is director, Dementia Research Service,
Burke Medical Institute.
To the Editor:
Throughout my life, I have seen the effects of Alzheimer's
disease on both the family and the person who receives
the diagnosis — first with my maternal grandmother
and then with my father, and then as a founder of
the Long Island Alzheimer's Foundation.
To my knowledge, not one of the pharmaceutical companies
that produce drugs for Alzheimer's has ever promised
that the drugs would stop or markedly slow the disease
(front page, April 7).
From day one, these drugs have been marketed for
what they are — the first step in slowing the
progression of an insidious disease whose cause
is still uncertain.
In my experience, for those accurately diagnosed
with Alzheimer's, the approved drugs are the closest
to a miracle we have so far. For some Alzheimer's
patients who take these drugs early enough in the
disease process, the stalling of the decline has
been truly remarkable.
JANET B. WALSH
Port Washington, N.Y., April 8, 2004"
