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Drugs can help Alzheimer's patients remain at home, study finds WASHINGTON (March 6, 1998 10:12 p.m. EST http://www.nando.net) - Drugs or herbs that help even a little can allow quite a few Alzheimer's patients to stay at home and out of nursing homes for longer, researchers said Friday. A 20 percent improvement in cognitive ability, such as knowing what day it is or remembering one's address, translates into a delay in patients having to enter a nursing home, said Dr. Bruce Kinosian of the University of Pennsylvania. "It's worth going for," Kinosian said in a telephone interview from a meeting of the American Medical Director's Association in San Antonio, Texas. "Out of a cohort of people with Alzheimer's disease what you would expect is that half would be dead in five years and about 36 percent would be in nursing homes," he said. Kinosian, a geriatrician, said he used a computer model that forecast a five percent reduction in nursing home admissions among Alzheimer's patients with a 20 percent improvement in cognitive ability. He said the five percent reduction would be an average over the whole group so the actual decrease in numbers entering nursing homes would be about 18 percent among those who survived. There are several drugs that can increase cognitive ability by about 20 percent or a little less. Kinosian's team used data from trials of metrifonate, which is made by Bayer. Bayer paid for the study. Metrifonate is under consideration for approval by the U.S. Food and Drug Administration (FDA). Already on the market is Aricept, made by Japan's Eisai Co Ltd and distributed by Pfizer. Kinosian says it also improved cognition by about 20 percent. Both drugs affect acetylcholinesterase, an enzyme that breaks down the neurotransmitter acetylcholine. Neurotransmitters carry signals between brain cells and acetylcholine is associated with cognitive functions such as memory, learning and judgment. Studies have shown that the worse someone is suffering from Alzheimer's, the lower their levels of acetylcholine. The idea behind Aricept is to make more acetylcholine available. Another drug is Warner-Lambert's Tacrine (cognex). It slows the progress of Alzheimer's in some patients, but has some side-effects in the liver that Aricept does not. Then there is ginkgo, a tree extract. A report in October in the Journal of the American Medical Association said that gingko could increase cognitive performance. Kinosian said his team used a standardized test of cognitive function. "What it does is, it identifies senility pretty well," he said. "It tests attention, because it does subtraction by threes, it asks who the president is, it asks birthday, it asks address." His team was somewhat surprised to find it was an improvement in cognitive ability that changed the likelihood someone would have to go into a nursing home. Alzheimer's can also cause behavioral and physical difficulties. Alzheimer's affects two to three percent of people over 65, or more than four million Americans. Forty-seven percent of people who live to age 85 have it. It is the fourth most common cause of death in late life. By MAGGIE FOX, Reuters Copyright 1998 Nando.net Copyright 1998 Reuters News Service janet paterson 50-9 / sinemet-selegiline-prozac almonte-ontario-canada / [log in to unmask]