The University of Nottingham

A drug commonly used to treat mild to moderate Alzheimer’s Disease (AD) can have positive benefits for patients in the later stages of dementia, research has found.

The study, involving academics at The University of Nottingham, is the first trial to establish that the dementia drug donepezil can be successfully used to treat patients with moderate to severe AD who have deteriorated beyond the point where the drug would currently be recommended.

It found the drug has even greater benefits for patients with severe AD than those in the earlier stages of the disease, the only group of patients that would normally be prescribed the treatment.

Dr Rob Jones of the University’s Division of Psychiatry, was among the experts who conducted the research, published in the New England Journal of Medicine. He said: “The National Institute for Health and Clinical Excellence (NICE) has advised use of this drug for people with mild to moderate dementia for some years but until now there has not been sufficient evidence to suggest its use is worthwhile in patients who are in the later stages of the illness.

“Our study has shown that the drug can have significant benefits to patients with severe dementia in slowing the decline in cognition and function. This large scale study has plugged a gap in our knowledge in a big way and this is important and helpful news for people with dementia and their carers.”

Around 750,000 people in the UK and 18 million worldwide suffer from AD. The multi-centre study, conducted in collaboration with King’s College London and funded by the Medical Research Council (MRC) and the Alzheimer’s Society, looked at two drugs: donepezil and memantine. Donepezil is the most commonly prescribed of the dementia drugs but doctors are currently advised to stop prescribing the drug when the disease progresses to moderate and severe because there has been no clear evidence that continuing treatment is beneficial to patients.

The study found that those patients who continued to take donepezil showed considerably less decline in cognition, including memory, orientation and language skills, and function (retained ability to carry out simple daily tasks and self-care) than those taking a placebo drug.

The benefits were clinically important and were actually greater than in patients with less severe AD. While the effect was slightly smaller, starting memantine treatment also resulted in significantly better cognitive and functional abilities compared with those taking a placebo.