Contributed by: Dennis Fortier, President, Medical Care Corporation
The message in this post may be one of the most important that the Brain Today blog regularly supports. Alzheimer's treatment is more effective than the typical news story reports.
This is evident by the news from the UK today, where their governing health authority, the National Institute of Health and Clinical Excellence (NICE), extended coverage of approved drugs for Alzheimer's patients in earlier stages of the disease. Authorities cited "better evidence" about treatment efficacy as the key motivator for the decision.
In general, the misconception about treatment effectiveness is based on three misleading frames of thought:
Drugs don't treat the disease, they only lessen the symptoms
Many well done studies support the claim that approved drugs offer no disease delaying effects. The problem with this frame of thought is that all of the studies have been conducted on patients who are demented due to Alzheimer's. Based on the long disease course, this means they are in a very advanced state of disease progression, and have already accumulated massive damage in the brain. As such, it is not surprising that drugs cannot delay disease progression when treatment is initiated at such a late stage. It stands to reason, and most experts agree, that the earlier stages of the disease are much more treatable.
The beneficial effects of drugs on symptoms last only a year or less
Again, there are many well done studies that support this notion. However, the studies isolate "drug treatment" in order to measure its effects, whereas in the real world, Alzheimer's treatment involves more than a drug. A robust treatment regimen includes proper diet, physical exercise, proper management of hypertension and diabetes, intellectual stimulation, social engagement, and an educated caregiver. Many patients derive meaningful, long-term benefits from such an approach, especially if the intervention is begun at an early stage of the disease. A drug alone may not be an effective treatment, but effective treatment does not consist of a drug alone.
There is no cure
This is absolutely true. But the public has a tendency to interpret that statement to mean "there is no treatment". For perspective, there is no cure for hypertension or for diabetes, but we commonly treat them, and the public generally acknowledges the benefits of such treatment. For sure, the efficacy of our Alzheimer's treatments pale in comparison to the efficacy of our hypertension/diabetes treatments, but we need a healthy appreciation for the difference between treatment and cure for Alzheimer's disease.
I hope this high level decision by the health authority in the UK will foster a growing optimism and a more clear perspective on treatment efficacy for Alzheimer's disease. I concur that we need better treatments than those available today, but we also need the public and the medical community to embrace a more constructive view of what can be done now.