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Tuesday, 18 July 2006 09:48 | BNN: British Nursing News Online · www.bnn-online.co.uk
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The use of the drug donepezil for Alzheimer's disease is to be limited by the NHS, although it has been shown to slow down shrinking of the brain.
In a study, the drug donepezil did more than relieve symptoms in patients with mild mental impairment - it also had an effect on the size of the brain. But under draft proposals from the National Institute for Health and Clinical Excellence (NICE), it could be limited to those with moderate Alzheimer's and not available to those with milder symptoms.
In Scotland, the Scottish Intercollegiate Guidelines Network recommends using the drugs at all stages of illness. But there are fears that once the NICE guidelines are finalised, they will also be adopted in Scotland and patients will no longer have access to them.
The latest study used MRI scans to measure brain shrinkage in 131 patients with mild cognitive impairment - some were given donepezil and others a dummy drug.
The study found that patients who were carriers of certain genes linked to cholesterol metabolism, the use of the drug resulted in slower shrinking of the hippocampus, the part of the brain that is the key to memory.
Dr Clifford Jack, of the Mayo Clinic in the United States, said: "Our study results seem to imply that donepezil does more than provide symptom relief - it has an effect on a measure of brain health”.
Kate Fearnley, the policy director of Alzheimer Scotland, said: "This research is further evidence of why NICE's recommendation to delay treatment until people have moderate Alzheimer's is fundamentally flawed.
"Although it's a small study, it is in tune with other research which shows the brain changes of Alzheimer's disease may start years before diagnosis”.
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