Drugs For Alzheimer's Disease Present Slower Cognitive Decline
Cholinesterase inhibitors, a group of drugs recommended for the treatment of Alzheimer's disease show persisting cognitive benefits and reduced mortality for up to five years after diagnosis as per a study at the Karolinska Institutet in Sweden, published in the journal Neurology.
Alzheimer's disease (AD) is a neurodegenerative disease that leads to gradual memory loss and behavioral changes. It is characterized by the formation of beta-amyloid plaques and the tau proteins in the brain tissues, years before the actual symptoms occur.
‘The treatment of Alzheimer's disease with cholinesterase inhibitors was shown to be associated with slower cognitive decline over five years. Moreover, a 27% lower mortality was observed in patients with Alzheimer's disease when compared to the controls.’
Having a profound impact on the lives of both patients and their families, AD is shown to affect around 100,000 people in Sweden who live with the diagnosis. Most of those who receive a diagnosis are over 65, but some patients are diagnosed in their 50s.
Approximately SEK 60 billion a year is the current cost of care and treatment for people with dementia in Sweden. This is on a par with the cost of care and treatment of cardiovascular diseases and is twice as high as cancer care.
Effects of Cholinesterase Inhibitors
Neurotransmitters are chemical messengers in the brain that helps the neurons to communicate with each other. Changes in several of these chemical neurotransmitters are found in the brain of Alzheimer's one such including - acetylcholine. It plays a key role in cognitive functions such as memory, attention, and concentration.
The three drugs that work as cholinesterase inhibitors (acting on acetylcholine reuptake) in the treatment of Alzheimer's disease are galantamine, donepezil, and rivastigmine. Among these common treatment options of AD, the effects of the cholinesterase inhibitors on cognition have long been debated because of very few studies that have investigated their long-term effects.
The present study conducted a registry study over five years from point of diagnosis of Alzheimer's disease. It included 11,652 patients treated with cholinesterase inhibitors and a matched control group of 5,826 untreated patients with the data utilized from SveDem (the Swedish Dementia Registry).
It was observed that treatment with cholinesterase inhibitors was associated with slower cognitive decline over five years, and 27% lower mortality in patients with Alzheimer's disease compared with the controls.
"Of all three drugs, galantamine had the strongest effect on cognition, which may be due to its effect on nicotine receptors and its inhibiting effect on the enzyme acetylcholinesterase, which breaks down the neurotransmitter acetylcholine," says the study's first author Hong Xu, a postdoctoral researcher at the Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet.
"Our results provide strong support for current recommendations to treat people with Alzheimer's disease with cholinesterase inhibitors, but also shows that the therapeutic effect lasts for a long time," says the study's last author and initiator Maria Eriksdotter, professor at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
Source: Medindia