Treating Alzheimer's: Where D... Video Transcript

Participants

Peter Davies PhD, David R. Marks MD, Norman Relkin MD, PhD

Summary

Alzheimer's disease, a slowly progressive disease of the brain, is the fourth leading cause of death among Americans over the age of 65. Although there is no cure, there are medical treatments available that can help control the progression of symptoms. By managing the illness, these treatments can greatly benefit patients and caregivers alike. Join our panel of experts as they discuss the state of the art in Alzheimer's treatment.

Webcast Transcript

DAVID MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Alzheimer's disease is the fourth leading cause of death in this country. There's no cure, but there are some treatment options for both doctors and caregivers, that can decrease the burden on the patient, the family, and all of society. We're going to hear about what some of these treatment options are, and about some future prospects for treatment.

We have two guests here. First is Dr. Norman Relkin. He's the director of the Cornell Memory Disorders Program at the Weill Cornell Medical College. Welcome.

NORMAN RELKIN, MD: Hello, David.

DAVID MARKS, MD: Hello. Also joining us, Dr. Peter Davies, the Resnick Professor of Alzheimer's Disease Research at Albert Einstein School of Medicine. Thanks for being here.

Treatment is the key. First there are some things that family can do to decrease the burden. What are those, quickly?

NORMAN RELKIN, MD: Recognizing the disease is the first step. After it's recognized, providing for the safety of the person who's affected is key. That means taking care of the things that they're either no longer able to take care of, or might be neglectful of as a function of their disease.

The non-pharmacologic part of managing Alzheimer's disease is looking after things like healthcare proxies, so that the person's future wishes about their healthcare can be determined before the disease progresses to a point where they're not able to make their wishes known. Consulting with an eldercare lawyer, making sure that there's safety around the home. A driving assessment, so that if the person's driving skills are affected, they don't place others at danger. There are many such interventions, and they are, I think, key. And perhaps equally important or more important than the pharmacologic means we have right now.

DAVID MARKS, MD: Let's talk about pharmacologic measures. What is out there that a doctor can prescribe for a patient with Alzheimer's?

PETER DAVIES, PhD: Currently there are only three FDA approved drugs for the treatment of the symptoms of Alzheimer's disease. There are a whole wealth of drugs that are used in patients with Alzheimer's disease, to manage agitation and depression. It's very important that caregivers and the patient don't accept that depression and agitation are untreatable problems and part of Alzheimer's disease. They are treatable, and it's important that families seek this kind of help from their physician.

In terms of treatment of the symptoms of Alzheimer's disease directly, the memory loss, the impairment of thinking, the current generation of drugs that are helpful, but not terribly so --

DAVID MARKS, MD: What are the names of the drugs?

PETER DAVIES, PhD: There are three approved currently by the FDA: Aricept, Exelon and Cognex. Those are the three that have been shown, in FDA-approved studies, to produce some beneficial effects in patients with Alzheimer's disease.

DAVID MARKS, MD: But you're not terribly impressed with the results, I gather?

PETER DAVIES, PhD: They're not a cure. They're not going to restore the patient to the way they were before the disease began. They do seem to be helpful, and there are positive effects in patients. They're not what we're looking for, by any means.

NORMAN RELKIN, MD: We are in a era in which the term "realistic expectations" always goes hand in hand with Alzheimer's pharmacotherapy, because the current treatments do not restore the person, except in a very, very mildly affected individual, to their previous state of mental health.