Drugs Can Delay Nursing Home Admission for Alzheimer’s

The benefits of the cholinesterase inhibitors drugs for treating early stages of dementia have sometimes been questioned. This may be because their effect is never dramatic, and the disease is progressive; and not all patients respond. But there’s no doubt that they have the ability to slow the inevitable deterioration in cognitive functioning by about 5 percentage points on recognized scales over a 6-month period.

The drugs we are talking about are donepezil (Aricept®), galantamine (Reminyl®), and rivastigmine (Exelon®). And the evidence for approval for use in Alzheimer’s patients was obtained from double-blind clinical studies measuring different scores on a variety of scales supposed to reflect the symptoms and signs of the disease. However, a new study from Florida shows that they may delay admission to nursing homes for up to 3 months. Records from the State Medicaid program followed patients over 60 with dementia who were either taking, or not taking, cholinesterase inhibitors and who had not been placed in a nursing home. Those already taking one of the drugs were significantly older, and included more women. The delay in admission averaged about 3 months.

Sadly, the benefit was not enduring. After 3 years, the proportion of patients placed in a nursing home was identical in the two groups, showing that the delay was only temporary. Nevertheless, one must assume the quality of life is better for the patient at home, and there’s a three-month savings in the cost of nursing home care amounting to roughly $12,000 (in Florida).