Posted on 10/12/2006 2:28:56 AM PDT by John Carey
The drugs most commonly used to soothe agitation and aggression in people with Alzheimer’s disease are no more effective than placebos for most patients, and put them at risk of serious side effects, including confusion, sleepiness and Parkinson’s disease-like symptoms, researchers are reporting today.
The report, based on a large government comparison of the drugs’ effectiveness, challenges current practice so sharply that it could quickly alter prescribing habits, some experts said. About 4.5 million Americans suffer from the progressive dementia of Alzheimer’s disease, and most patients with the advanced disease exhibit agitation or delusions at some point.
The drugs tested in the study — Zyprexa from Eli Lilly; Seroquel from AstraZeneca; and Risperdal from Janssen Pharmaceutical — belong to a class of medications known as atypical antipsychotics. The drugs are used to treat schizophrenia and other psychoses, and are commonly prescribed for elderly patients in long-term care facilities.
(Excerpt) Read more at nytimes.com ...
First: I am no relation to the NYT writer.
Second: this is sad news indeed.
We all have to become aware, or more aware, of Alzheimer's. We are all getting older. Modern medicine can keep your body going longer. But medicine has not, it seems, kept up with how best to keep your ageing mind sharp.....
Huge cost of Alzheimer's
By John E. Carey
The Washington Times Commentary
September 21, 2006
Today is World Alzheimer's Day, set aside by Alzheimer associations around the world to concentrate on raising awareness about dementia. There are an estimated 24 million people around the world who currently have dementia.
Alzheimer's is one of the costliest maladies draining insurance companies and family savings. And because the medical community is now able to help us live longer lives, the number of Alzheimer's sufferers is increasing at an alarming rate.
In June 1999, Rep. Ed Markey, Massachusetts Democrat, and Rep. Chris Smith, New Jersey Republican, joined as co-chairs of the Bipartisan Congressional Task Force on Alzheimer's Disease, a task force that continues providing an immeasurable degree of leadership.
Sens. Hillary Clinton, New York Democrat, and Susan Collins, Maine Republican, head the Senate effort. Both are active, vigorous and conscientious advocates.
Congressional committees responsible for funding Alzheimer's research and treatment projects voted to limit or decrease most projects in the budget now under consideration on Capitol Hill.
Alzheimer's disease is a progressive brain disorder that gradually destroys a memory and ability to learn, reason, make judgments, communicate and carry out daily activities. As Alzheimer's progresses, individuals may also experience changes in personality and behavior, such as anxiety, suspiciousness or agitation, as well as delusions or hallucinations.
Because Alzheimer's is a disease, a malfunction if you will, in the brain, patients and their families often experience difficulty in properly diagnosing the disease and getting treatment. While doctors often rely heavily on the patient's complaints to diagnose other diseases, a patient with Alzheimer's may be unable or reluctant to describe his or her own confusion and distress.
Add to that, the patient may be reclusive, untrusting and/or overly proud. The patient may suffer through long days of confusion and misinterpretation, only to rally in front of the doctor and hide any hint of disability.
My friend Ron may be the classic example of Alzheimer's disease running amok in a sufferer both confused and no longer able to routinely make rational decisions others take for granted. He is not only unable to make the decisions; he agonizes over simple decisions for days or weeks at a time.
And Alzheimer's disease sufferers can be dangerous, in extreme cases, to themselves and others. Ron has had three recent car accidents. His insurance policy was revoked. But, unable to properly self-diagnose and afraid a doctor might recommend he stop driving, Ron, like untold numbers of others, retains his license, continues to drive, and found new, though more expensive, insurance coverage.
We experienced the agony of Alzheimer's in our own family. My mother progressed over several years from exhibiting slightly odd behavior to the stage we all most fear. She became almost a totally different person. She became both difficult to care for and hard to love. She eventually needed full time nursing home care: a costly proposition even for the well-heeled and adequately insured.
Fortunately, there is lots of help available. Help groups, seminars and treatment opportunities abound. In my county, for example, people over age 65 can ride a taxi almost anywhere for $1 so nobody who feels unsafe doing so needs to drive.
What are the costs of a progressive brain disease on an aging society?
At the 10th International Conference on Alzheimer's Disease and Related Disorders (ICAD), in Madrid in July 2006, Dr. Anders Wimo of the Stockholm Gerontology Research Center and Aging Research Center at Karolinska Institute, Sweden, said worldwide costs of dementia care (combined direct and informal costs) is around $248 billion annually. This overlooks the fact many suffer the ill effects and still receive no care and that our aging population is growing at a breathtaking rate.
"These startling cost estimates for Alzheimer's care clearly illustrate the great challenges faced by both families and our national health-care systems as the number of people with Alzheimer's continues to grow," said William Thies, Alzheimer's Association vice president of medical and scientific relations. "Increasing the funding for Alzheimer's research into early detection, better treatment and prevention is critical to curbing this impending world health disaster. We can fund research now or wait for Alzheimer's to overwhelm the health systems in the U.S. and throughout the world."
According to the Department of Health and Human Services Administration on Aging, the older population -- persons 65 years or older -- numbered 36.3 million in 2004 (the latest year for which data are available). They represented 12.4 percent of the U.S. population, about 1 in 8 Americans. By 2030, there will be about 71.5 million older persons, more than twice their number in 2000. People 65 and older represented 12.4 percent of the population in the year 2000 but are expected to grow to 20 percent of the population by 2030.
According to the U.S. Alzheimer's Association, Medicare costs for people with Alzheimer's will be more than $1 trillion by 2050 and Medicaid costs for nursing home care alone will be about $118 billion.
Nobody can say for sure how many among us will have Alzheimer's in the future but some experts say we will have 16 million or more Alzheimer's sufferers in America by 2050. The treatment costs will certainly be staggering.
"All too often, seniors are unable to access adequate mental health care in their communities, even when they have access to other health care services in places like local community centers," said Miss Collins, who works closely in the Congressional Task Force on Alzheimer's Disease with Mrs. Clinton and others.
Add to this health-care crisis an often overlooked segment of the population that Mrs. Clinton often discusses: patients and sufferers from Early Onset Alzheimer's Disease. These are younger sufferers; people sometimes as young as 50.
"Alzheimer's doesn't just affect the elderly," Mrs. Clinton said. "When Alzheimer's disease or other dementias unexpectedly strike younger individuals, they face daunting challenges in addition to the disease itself, like difficulty obtaining a diagnosis, early retirement and the loss of jobs and income."
Congressional funding for Alzheimer's education, research and related programs such as 24-hour-a-day, seven-days-a-week Call Centers, the National Family Caregiver Support Program, and other efforts, is never easily secured. Congressional committees with oversight and funding authority for Alzheimer's projects have already recommended cutting funds for several Alzheimer's programs in this budget cycle and the House and Senate are not expected to vote on Alzheimer's projects until after the November elections.
"Although we have made progress in the awareness, diagnosis, and treatment of Alzheimer's over the past 15 years... we must do more," Mrs. Clinton said. "We must continue to make this disease a national priority. This means directing more resources to learn how to identify early onset dementia and stop its progression.
"I am hopeful that together we can combat this disease and do all we can to bring hope, help and an eventual cure to the millions of Americans with Alzheimer's."
John E. Carey is the former president of International Defense Consultants Inc.
http://www.washtimes.com/commentary/20060920-090610-2909r.htm
Substances like ibuprofen and curcumin may prevent Alzheimer's.
DAMMM!
I'd bet valium, etc. would work better
We moved her into the facility in July. I went to visit her a couple weeks ago, and she didn't know who I was. Nonetheless, we shared coffee and gingersnap cookies, and she treated me as some new friend she had acquired for the first time.
I thought I'd be able to handle it, but I haven't gotten over it since.
It's a rotten, terrible disease, and it's the first time I've ever had to come face to face with it.
Fear not. As a clinical researcher who's now on Aricept for MS related dementia and memory issues. I can see where none of these meds would work for Alzheimers dementia or PRD.
The Aricept and Execelon class drugs are doing wonderful things for folks like me with early stage issues.
Further, can't quote you the study right now, I have read that Aricept and Execelon can delay the progress of the dementia and memory loss.
Thanks for the ping. Its nice to see what is going on out there in the area.
I've read this before, but I can't remember where or when.
I was going to mention Aricept. I have MS (I don't use Aricept) but I've heard good things about it. Glad it's working for your cognitive issues.
I knew an elderly person who was on Risperdal. IMHO, the side effects from the drug were very severe and the benefit from the drug, hardly noticeable (they didn't use the drug for Alzheimer's but for agitation.)
Namenda helps a little.
She's at a stage where she isn't just forgetful but her personality has changed. Once she was the nicest person you could meet. Now she is always miserable and mean. Part of it is because she just doesn't feel good with all her other health issues.
I'm trying to keep her at home as long as I can but at some point I think I'll have to put her in a home. The stress of caring for her is getting very intense. There are times when I feel like I'm going to stroke out or something. I get mad at myself for feeling that way because my mother certainly is so much worse off.
bump to read later.
Tx, again, John.
bump for later read
Your lips to Gods ears.
No longer working at least on the job. Everyday in my head "I get up and go to work" I miss the work terribly.
But I am adjusting well. What's the alternative?
You can be sick and miserable or just sick. I'll pick door number 2. Attitude is everything.
Could be worse!
I could be a liberal!
My 87 year old mother who is in the last stages of Alzheimers, lives with us and is cared for by my wife. The first thing that we did was remove her from the several medications that had been prescribed (Paxcil, Aricept, etc.) and found that her demeanor improved. That was three years ago and she is still 'drug free'. What works best is a peaceful environment to finish up in.
Bless your heart. While I was spared from dealing with long-term care issues with both of my late parents, I have "walked alongside" several (too many) friends who have had parents with Alzheimer's. Nearly all wound up with PTSD-like symptoms themselves.
My closest friend who I felt handled it the best (and the longest, for many years) did so by not losing her sense of humor. I was the person who would let her tell the funny stories - which weren't really funny, but tragic on their surfaces - when the days had gotten so bad.
It kept her from taking personally the "bad behavior" directed towards her, the only caregiver. It may seem impossible to laugh, but find a trusted friend who understands and won't judge you with "how can you think that about a person who is so ill" and shaming techniques like that.
Then live, love, laugh as much as possible - and save your own sanity. Best of luck to you.
Part of the problem with meds for my mother is the fact she only weighs 69 pounds. She often can't handle adult doses, something doctors seem to forget.
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