Dementia drugs may delay admission to residential care
Caroline White
Monday, 3 October 2011
Prescribing dementia drugs to elderly patients with the condition might help delay their admission to care homes, suggests research published in The Psychiatrist. But the effect seems to be relatively short-lived, suggests the research.
The research team looked at the long term mental health of 339 people with dementia, who were referred to psychiatric services in 2006. Two thirds were women, and the average age at referral was 82.
Over half were diagnosed with probable Alzheimer's disease; one in three had possible Alzheimer's disease; one in 10 had Parkinson's disease related dementia or other dementias.
One in four (127) of the patients had been prescribed cholinesterase inhibitors to slow progression of their dementia.
Almost three quarters (74%) of this group were being treated with Aricept. The rest were taking either Reminyl (14%), Exelon (8%), or Ebixa (4%). The other 212 patients were not prescribed cholinesterase inhibitors.
After four years, the researchers traced all 339 patients to see if they had been placed in care or remained in their own home.
One in five (68) people had been admitted to a care home. On average, patients who did not take anti-dementia drugs moved to care homes around 12 months sooner than their peers who did—but only during the first 2.5 years of treatment.
After three years, an equal proportion of patients from both treatment groups had been admitted to care homes.
Average survival from referral was just under 3 years, with the average period of survival in a care home 18 months. Almost twice as many people who had been prescribed cholinesterase inhibitors were alive at the end of the four year period.
Consultant psychiatrist and lead author of the research, Dr Emad Salib of Liverpool University, said: "Our study provides some evidence to suggest that prescribing cholinesterase inhibitors is associated with a delay in care home placement in the first 2.5 years of treatment. However, we cannot say whether this association is causal or if it is the result of a number of different factors."
He added: "Moving a person to a care home is a significant and distressing event both for the individual and their family, and most carers wish to maintain home care for as long as possible."
He cautioned: "Any measure that may help to delay institutional care is invaluable, but we must ensure the evidence is robust."
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