A class of drugs known to ease the memory loss of Alzheimer’s patients may also improve behavioral problems and the ability to perform everyday chores, says a study out Wednesday.
The drugs, known as cholinesterase inhibitors, are not widely prescribed for the 4 million Americans suffering from Alzheimer’s today because they only provide a modest boost in memory for many patients. But the added benefits suggested by this study might spur more doctors to prescribe the FDA-approved drugs.
Such a step would, in some cases, delay admission to a nursing home, which is often triggered by difficult-to-manage behaviors - such as aggression - that can accompany the forgetfulness that is the hallmark of Alzheimer’s.
Kristine Yaffe, a neurologist and psychiatrist at the University of California-San Francisco, and her colleagues have collected data from 29 already published trials of cholinesterase inhibitors. Some of those studies hinted that the drugs could help ease behavioral troubles but didn’t have enough patients to prove that benefit. So Yaffe’s team lumped the findings from each study together to determine a result.
They then found that people with mild to moderate Alzheimer’s disease who were taking the drugs did better over time on tests that assess behavioral problems as well as the ability to perform routine tasks such as balancing a checkbook, talking on the phone, or getting dressed.
“Now we have pretty good evidence that these drugs help,” Yaffe says. The results are published in TheJournal of the American Medical Association.
For family members trying to care for an Alzheimer’s patient, even small behavioral changes might have a big impact, notes Bill Thies, vice president of medical and scientific affairs at the Chicago-based Alzheimer’s Association.
These drugs might prevent wandering, a problem that can be a significant source of worry for caregivers, he says. Or they might help a patient perform a daily chore such going to the grocery store, he says.
Thies says that some of the studies in this report had tested tacrine, an older drug that isn’t prescribed much anymore because it can cause liver damage. But Yaffe says the results held true even when the researchers looked at the more recently approved drugs like rivastigmine, donepezil or galantamine.
Family members caring for an Alzheimer’s patient should ask the doctor about cholinesterase inhibitors, which work by slowing the body’s breakdown of a neurotransmitter that plays a role in memory. Some scientists believe this same brain chemical may help prevent the behavioral difficulties that can afflict an Alzheimer’s patient.
But experts say these drugs are no cure for this degenerative brain disease.
“What we all want is a drug that stops the progression of Alzheimer’s,” Thies says. “These drugs don’t do that.”
Revision date: July 7, 2011
Last revised: by Andrew G. Epstein, M.D.