Donepezil can help individuals with severe forms of the brain disease

Donepezil, a drug prescribed for people with mild to moderate Alzheimer's, can help individuals with severe forms of the brain disease, a study published on Thursday says.
Donepezil was tested for six months among 95 Swedish nursing-home patients with severe dementia, and compared against 99 similar patients who were given a placebo, a harmless lookalike tablet. The patients were assessed, both before and after the test, on a range of cognitive skills and basic coping skills. Those on the donepezil showed good improvements in memory, orientation, language and spatial awareness, and their decline in coping skills such as bathing, grooming, bowel and bladder function either slowed or stabilised. The drug was well tolerated. The study, published online by The Lancet, is led by Bengt Winblad, a professor of geriatrics at Sweden's Karolinska Institutet. Several theories compete as to the cause of Alzheimer's. One of them suggests the disease is caused by a deficiency in chemicals called neurotransmitters that are used by brain cells to communicate with each other. Donepezil and other drugs in its class inhibit acetylcholinesterase, an enzyme responsible for the destruction of an important neurotransmitter, acetylcholine. As a result, levels of acetylcholine in the brain are increased, which apparently causes the improvement in symptoms. These drugs improve symptoms but do not halt them, nor do they stop the underlying progression to dementia and eventually death. The two other hypothesis say the cause lies with tangles of protein called tau or with deposits of a plaque protein called beta amyloid that also are the hallmarks of Alzheimer's. Global population growth, greater longevity and changing lifestyles in developing countries point to an explosion in incidence of Alzheimer's in the coming decades, according to a paper published last December. Twenty-four million people today have Alzheimer's and the figure will rise to 42 million by 2020 and 81 million by 2040, it said. Donepezil is manufactured by Pfizer Pharmaceuticals under the brand Aricept.

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