Experts have urged GPs to keep prescribing the drug donepezil to patients in the later stages of Alzheimer’s disease because they say it can help them to continue living at home for longer.
The researchers report in the Lancet Neurology that withdrawing the drug in the late stages of disease – often done because of doubts it continues to help patients’ cognitive function or ability to carry out daily activities – doubled the risk of patients having to move into a care home within a year.
The study, backed by the Medical Research Council and the Alzheimer’s Society, included 295 people with moderate to severe Alzheimer’s disease, who were taking donepezil 10 mg daily.
The patients were randomly selected to either continue on the drug or switch to placebo, with each group then further randomly assigned to take memantine 20mg daily or a placebo.
While a similar proportion of each group ended up in a care home after four years, the patients who discontinued donepezil were twice as likely to be placed in a care home in the first year as those who stayed on the drug. Starting on memantine had no effect either in the first year or over the next three years, however, the researchers reported.
Dr Doug Brown, director of research and development at Alzheimer’s Society, said: ‘These robust findings are of real significance to people with dementia and their families who want to continue living at home for as long as possible.
‘We urge clinicians to consider the implications of this research and adjust their prescribing patterns accordingly.’
Lancet Neurol 2015; available online 27 October