Dementia drug delays older people's need for care homes

People with Alzheimer’s can stay in their own homes longer and delay their move to a care home, as long they take donepezil, research reveals.

A 12-month study by University College London (UCL), published in The Lancet Neurology, reveals those living at home with moderate to severe Alzheimer’s were twice as likely to enter a care home after a year, if they stop taking donepezil.

The placebo-controlled trial by UCL, involved 295 people with Alzheimer’s who were still living at home and had care workers living with them or visiting them at least once a day.

The study's findings indicate the cheap drug, costing only £21.59 a year, gave patients a mental boost with about 32 per cent less cognitive decline in those taking donepezil than those on a placebo.

Research lead Professor Robert Howard said: “Donepezil blocks the natural breakdown of acetylcholine in the brain which affects memory.

“We are not claiming that it is slowing down the Alzheimer’s process in the brain."

The study shows donepezil has benefits for people with moderate to severe Alzheimer's disease, which is beyond current NICE prescribing guidelines – which recommend doctors prescribe donepezil for mild to moderate stages only.

Specialists tend to stop giving donepezil to patients when Alzheimer’s becomes severe but the study’s findings indicate such action only speeds up an older person’s loss of independence and entry into a care home.

Professor Howard hopes the study will result in more older people continuing to receive the drug. He said: “It’s really important that people know not to stop these drugs.

“It will allow people to stay in their homes longer."

Referring to the practice of withdrawing donepezil for patients with severe Alzheimer's, the professor said: “Our research shows this is a bad idea for people’s cognitive function and will mean they lose activities they do as part of daily living, such as being able to wash themselves and cloth themselves.

The study's research paper stated: “Decisions to stop or continue donepezil treatment should be informed by potential risks of withdrawal, even if the perceived benefits of continued treatment are not clear.”

The study was funded by the Medical Research Council and UK Alzheimer's Society.