8 out of 10 UK doctors criticise Alzheimer’s treatment

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London: Most doctors feel Alzheimer’s sufferers do not receive sufficient treatment, according to a new survey.

The IMPACT (Important Perspectives on Alzheimer¬ís Care & Treatment) study explored the views of 1800 people – physicians (GPs and specialists),1 Alzheimer’s carers,1 payors1 and the general public1 in France, Germany, Italy, Spain and the UK.

According to the new study presented at the 2009 Alzheimer¬ís Association International Conference on Alzheimer¬ís Disease (ICAD 2009), almost 8 out of 10 UK physicians (77 percent)1 consider Alzheimer’s disease to be undertreated in the UK.1 These perceptions reflect behaviours identified in earlier research by the Audit Commission for Local Authorities and the National Health Service which highlighted an uncertainty in diagnosing any form of dementia by GPs in the UK, with 40% of GPs reluctant to refer early for diagnosis.2

According to the study, supported by Eisai and Pfizer Inc, UK doctors feel the medical community hesitates in discussing the earliest stages of Alzheimer¬ís disease because of their uncertainty.1 Furthermore, 63% of responders from the general population, many of whom could be tomorrow’s carers, felt that most people would have difficulty identifying the early signs of the disease.1

¬ďThe National Dementia Strategy sets out a clear direction for dementia management and if adhered to closely, it could help the UK lead the way in Alzheimer’s disease care and management. Today’s survey findings suggest that although we are making progress, we still have a long way to go. Alzheimer’s disease needs to be tackled with the same force as the fight against cancer and we need to act now in order to halt this generational time bomb”, said Professor Roy Jones, Clinical Gerontologist and Geriatrician at The Research Institute for the Care of Older People, Bath, and Study Steering Committee Chair.

Alzheimer¬ís disease, the most common type of dementia, affects nearly half a million people in the UK3 ¬Ė a figure expected to double within twenty years.4 According to IMPACT, Alzheimer¬ís disease is the most feared disease after cancer in the general population,1 with physicians1 and carers1 being the only groups surveyed to fear it even more than cancer. In 2007, the annual cost of caring for people with Alzheimer’s disease was ¬£11 billion,5 with dementia costing the UK economy over ¬£17 billion a year,6 more than cancer, stroke and heart disease combined.5 Additionally in 2007, Alzheimer¬ís disease research received 3 percent of the funds spent on cancer, a disease that affects a similar number of people.5

While the study revealed that UK doctors face a number of barriers to early drug treatment,1 it also showed that according to physicians in the UK, the medical community is more likely to recommend third party support (e.g. patient organisations) after the diagnosis of Alzheimer’s disease than in France, Germany, Italy and Spain.1

Marc Wortmann, Executive Director of Alzheimer¬ís Disease International and member of the IMPACT Study Steering Committee, said, ¬ďIt is reassuring to note that the benefits of support groups are clearly recognised by clinicians and hopefully experienced by carers and patients. We strongly support the tendency to refer to patient groups at diagnosis, as it is well known that seeking support improves the quality of life for people living with Alzheimer’s disease and eases the burden for the carer.”

About Alzheimer’s disease

Alzheimer’s disease, a progressive and degenerative brain disease,7 is the most common type of dementia7 and affects more than six million Europeans.8 Symptoms of Alzheimer’s disease may include increased forgetfulness, repeating or asking the same question frequently, and problems making decisions.9

These symptoms gradually affect a person’s cognition, behavior and everyday activities, some severe enough to have an impact on their work, social activities and family life.9 While there is no cure for Alzheimer’s disease, there are treatments to help slow the progression of the symptoms of the disease.10

About the IMPACT Study

The IMPACT study was conducted online within the United Kingdom, France, Italy, Spain and Germany by IPSOS on behalf of Eisai and Pfizer Inc between April 1 and May 1, 2009, among 500 physicians (including general practitioners and specialists), 250 AD carers, 50 payors and 1,000 members of the general population age 18 and over. Statistical differences are noted using a 90% confidence interval. A full methodology is available upon request.

About the IMPACT Study Steering Committee

The IMPACT study was developed and implemented with the oversight of an expert Steering Committee comprised of a variety of leading AD specialists, including geriatricians, neurologists, epidemiologists, primary care physicians and old-age psychiatrists from the United Kingdom, France, Italy, Spain and Germany. The Executive Director of Alzheimer Disease International (ADI) was also part of the committee. Most members of the IMPACT Study steering committee received honoraria for their participation. The Committee was supported by Eisai and Pfizer Inc.

About Eisai

Eisai is a research-based human health care (hhc) company that discovers, develops and markets products throughout the world. Eisai focuses its efforts in three therapeutic areas: Integrative Neuroscience including neuroscience, neurology and psychiatric medicine; Integrative Oncology including oncotherapy and supportive-care treatment and Vascular/Immunological Reaction which includes acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis and Crohn’s disease.

Through a global network of research facilities, manufacturing sites and marketing subsidiaries, Eisai actively participates in all aspects of the worldwide health care system. Globally, Eisai operates in five key regions: its home market of Japan, North America, China, Asia/Oceania/Middle East and Europe and employs more than 11,000 people worldwide.

About Pfizer

Pfizer Inc., founded in 1849, is dedicated to better health and greater access to health care for people and their valued animals. Every day, colleagues in more than 150 countries work to discover, develop, manufacture and deliver quality, safe and effective prescription medicines to patients.
In the UK, Pfizer has its European R&D headquarters at Sandwich and its UK business headquarters in Surrey, and is the major supplier of medicines to the NHS. Pfizer¬ís annual UK R&D investment is more than ¬£550 million ¬Ė more than ¬£10 million a week.

1 Impact Study 2009: Global Alzheimer’s Awareness Study. Data on File Eisai, Pfizer Ltd

2 Audit Commission Update, Forget Me Not 2002: Developing Mental Health Services For Older People In England. Audit Commission February 2002.

3 Alzheimer¬ís Society Factsheet available at What is Alzheimer’s Disease?.
4 Alzheimer’s Society. Facts for the Media.
5 Alzheimer’s Research Trust. Annual Review 2007. February 1, 2007.
6 Alzheimer’s Research Trust. Dementia Statistics. Available at: Dementia Statistics.
7Alzheimer¬ís Association. 2008 Alzheimer¬ís Disease Facts and Figures. Available at: Alzheimer’s Disease Facts and Figures.
8 Alzheimer Europe. Policy watch Europe Unites Against Alzheimer’s disease. Dementia In Europe: The Alzheimer Europe Magazine. December 2008;2: 9.
9 Alzheimer’s Association. 10 Signs of Alzheimer’s Signs of Alzheimer’s Disease
10 Alzheimer’s Association. Treatments Available at Treatments and Treatments

Reduce your risk of dementia

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London: The Alzheimer’s Society today launched a national campaign to reduce people’s risk of dementia as the count down to Dementia Awareness Week begins.

Running from the 6 ¬Ė 12 July 2008, Dementia Awareness Week will challenge people to reduce their risk of developing dementia, a condition that affects one in three people who live past the age of 65. Already over 700 000 people in the UK have dementia and millions more families are affected. This number is set to increase dramatically to over a million people by 2025.

Alzheimer’s Society Ambassadors, Fiona Phillips, Russell Grant, Lynda Bellingham and Ruth Langsford are among the high profile supporters of the campaign.

Alzheimer¬ís Society is launching a revised edition of ¬ĎBe head strong¬í, a free advice booklet showing how people can reduce their risk of dementia. It contains nutritional information on what types of foods to eat, exercise activities and information to help dispel existing myths about dementia.

The booklet urges people to follow a healthy diet, get active and not smoke. People are also being encouraged to visit their GP and get their blood pressure and cholesterol checked.

A recent survey by Alzheimer’s Society found that dementia is the condition we fear most in old age yet many people do not realise there are things we can do to reduce our risk.

Background information
¬∑ Copies of the Alzheimer¬ís Awareness Week brochure ¬ĎBe Headstrong. Challenge your risk of Dementia¬í are available on request.

· www.challengedementia.org.ukwill be launched on 24 April 2008 containing information to reduce your risk and

· 1 in 3 older people will end their lives with a form of dementia

· 700,000 people in the UK have a form of dementia, more than half have Alzheimer’s disease. In less than 20 years nearly a million people will be living with dementia. This will soar to 1.7 million people by 2051. 1 in 6 people over 80 have dementia.

· Alzheimer’s Society champions the rights of people living with dementia and those who care for them. Alzheimer’s Society works in England, Wales and Northern Ireland

· As a charity, Alzheimer’s Society depends on the generosity of the public to help it care, research and campaign for people with dementia. You can donate now by calling 0845 306 0898 or visitingwww.alzheimers.org.uk

· Alzheimer’s Society Dementia Helpline number is 0845 300 0336 or visit www.alzheimers.org.uk

Anti-depressants don’t work, says new research

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London: People suffering from depression are getting few benefits from drugs to treat their symptoms, researchers at a UK university have concluded.

Researchers at the University of Hull analysed studies of thousands of patients on some of the most widely-prescribed drugs such as Prozac, Seroxat and Efexor – to discover that they may as well take “placebos”.

They said the drugs were only effective in improving the mental health in extreme cases.

The study, which has been published in the journal PLoS Medicine, suggests hundreds of thousands of Britons are needlessly taking powerful – and potentially dangerous drugs.

Their report has also been handed to the US’s Food & Drug Administration.

A number of serious side-effects have been associated with these drugs including suicide and suicidal thoughts, side-effects which are known as SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressants. Other side effects have included self harm to anxiety, insomnia, nausea, headaches and vomiting.

Seroxat alone has been linked to at least 50 suicides – both adult and child – in the UK since 1990.

The research comes as prescriptionsfor anti- depressants are at record levels, with 31million written in 2006 at a cost to the NHS of almost £300million. Around half of these were for Prozac, Seroxat, Efexor and other SSRIs.

Researcher Professor Irving Kirsch said: ‘Given these data, there seems little evidence to support the prescription of anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide benefit.’

Professor Kirsch, a psychologist, reached his conclusion after combining the results of 35 clinical trials involving more than 5,000 patients with depression.

Two-thirds of those taking part in the studies were prescribed the SSRIs, while the remainder took placebo tablets.

Comparison of the two groups showed that in the majority of cases the mental health of those taking anti- depressants improved little more than those on dummy pills.

Only those who were extremely depressed – a very small proportion of those studied – fared substantially better when on medication.

The results suggest that those taking the tablets mainly benefit from the ‘placebo effect’ – in which symptoms are eased not by medication but by relief in diagnosis and the simple expectation a treatment will work.

Mental decline is No1 fear of ageing

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London: Research conducted by Help the Aged has revealed that the UK public rank mental decline higher than any other worry about ageing, including big issues like the pensions crisis and the fear of isolation (1).

In response to this concern, the Charity has launched a new website www.disconnectedmind.org.uk to help mobilise public support for one of the world’s most promising scientific projects to combat the condition.

Help the Aged has committed to fund this historic project, called The Disconnected Mind, through to its conclusion in 2015. Donations are needed now to maximise the possibility of a breakthrough in the fight against early mental decline that usually leads to dementia (2).

The project is unique because the scientists leading the study at the University of Edinburgh will revisit 1,000 volunteers, who are now aged 71, who took part in the Scottish Mental Survey in 1947 ¬Ė a survey that has not been repeated since. The project will compare the participants¬í childhood mental ability, current ability, biological health and 60 years of life experience.

www.disconnectedmind.org.uk uniquely divides the project into tangible pieces so that the public can see how any donation from them, however small, can make a big difference. For example, just £45 would fund the in-depth examination of one participant’s test results, which could hold the secret to the prevention or treatment of mental decline.

Early mental decline often leads to dementia that affects 700,000 people in the UK. Tragically, this is expected to rise to over a million by 2025 unless new ways are found to combat it.

More details on the survey:

(1) Survey by GfK NOP for Help the Aged. A sample of 1000 adults aged 16+ in the UK were interviewed during the weekend of 4th ¬Ė 6th May 2007. This survey was designed to be nationally representative of the telephone owning population of the UK. It revealed that mental decline ranks higher (41% of responses) than any other concern about ageing, including big issues like the pensions crisis/lack of savings and fear of isolation. Initial mental decline often leads to full dementia which the survey revealed is the age-related health condition of greatest concern, with 53% of respondents ranking it above strokes, incontinence and osteoporosis.

(2) Four out of five people who experience mild mental impairment go on to develop dementia within six years.

The team of experts at the University of Edinburgh performing The Disconnected Mind project are Professor Ian Deary, Doctor John Starr, Professor Jim McCulloch, Professor Joanna Wardlaw, Professor Richard Morris and Doctor Karen Horsburgh.
Help the Aged is the charity fighting to free disadvantaged older people in the UK and overseas from poverty, isolation, neglect and ageism. It campaigns to raise public awareness of the issues affecting older people and to bring about policy change. The Charity delivers a range of services: information and advice, home support and community living, including international development work. These are supported by its paid-for services and fundraising activities – which aim to increase funding in the future to respond to the growing unmet needs of disadvantaged older people. Help the Aged also funds vital research into the health issues and experiences of older people to improve the quality of later life.

Chantix anti-smoking drug gets mental health warning

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New York: Pfizer, the manufacturer of anti-smoking drug Chantix, has updated its label to include a warning on mental health symptoms.

CHANTIX¬ģ was approved in the US in May of 2006 as an aid to smoking cessation. Since then there have been a number of cases of suicide and suicidal behaviour by those taking Chantix. A causal relationship between the drug and these symptoms has not been established.

But the manufacturer has now included a warning on the CHANTIX label in the US that patients who are attempting to quit smoking with CHANTIX should be observed for serious neuropsychiatric symptoms, including changes in behavior, agitation, depressed mood, suicidal ideation and suicidal behavior.

The current update, based on Pfizer and FDA’s ongoing safety review of post-marketing reports, is provided to better ensure that healthcare providers and patients will appropriately consider this information in their discussions about CHANTIX.

A causal relationship between CHANTIX and these reported symptoms has not been established. In some reports, however, an association could not be excluded. More specifically, some reports may have been complicated by the symptoms of nicotine withdrawal in patients who stopped smoking, but not all patients with these symptoms had quit smoking. Some patients with pre-existing psychiatric illness experienced a worsening of their conditions. By heightening awareness of these post-marketing events and facilitating this discussion, patients and doctors can play an important role in mitigating potential risk and ensuring the full benefits of CHANTIX can be realized.

In the controlled clinical trial program of more than 5,000 patients treated with CHANTIX, changes in behavior, agitation, depressed mood, suicidal ideation, and suicidal behavior occurred at a rate comparable to placebo-treated patients. There were no suicides attributed to CHANTIX in clinical trials. Patients with serious psychiatric illness such as schizophrenia, bipolar disorder, and major depressive disorder did not participate in the controlled clinical trial program.

CHANTIX, a selective nicotinic acetylcholine receptor partial agonist, is the first non-nicotine prescription treatment for smoking cessation in almost a decade. It has been prescribed to more than 4 million patients in the United States since approval.

Folate shown to slow dementia, says new US report

New York: A folate study has revealed that the vitamin can slow the cognitive decline of ageing.

The research, presented at the recent US Alzheimer’s Association¬ís first conference on prevention of dementia, demonstrated that otherwise healthy people could slow the decline in their brain function by taking double the recommended daily dose of folate.

Scientists found that men and women 50-75 years old who took 800mcg of folate a day over three years scored significantly better in cognitive tests than peers taking a placebo. On memory tests, the supplement users had scores comparable to people 5.5 years younger, said the researchers from Wageningen University in the Netherlands.

“It’s the first study to convincingly show that [folate] can slow cognitive decline,” said lead author Jane Durga. The study involved healthy older people, not those with Alzheimer’s symptoms, so it doesn’t show if folate might ward off that disease. “That’s the key question,” Durga said.

Previous research has suggested that folate along with other B vitamins can reduce levels of homocysteine, an amino acid thought to play a role in the onset of Alzheimer’s disease.

The current study involved 818 middle-age adults who had elevated levels of homocysteine at baseline. They were randomized to receive either folate or a placebo for three years. Blood folate levels for those in the supplement group increased five-fold and plasma total homocysteine concentrations decreased by around 25 per cent by the end of the study.

“I think I would take [folate], assuming my doctor said it was OK,” said Johns Hopkins University neuroscientist Marilyn Albert, who chairs the Alzheimer’s Association’s science advisory council.

“We know Alzheimer’s disease, the pathology, begins many, many years before the symptoms. We ought to be thinking about the health of our brain the same way we think about the health of our heart,” she added.

Folate is found in such foods as oranges and strawberries, dark green leafy vegetables and beans. In the United States, it also is added to cereal and flour products.

Durga said it’s not clear how folate might work to protect the brain. Some studies suggest folate lowers inflammation; others suggest it may play a role in expression of dementia-related genes.

There is research now suggesting ways to protect the brain against age-related memory loss and Alzheimer’s. The Alzheimer’s Association has begun offering classes to teach people the techniques. Topping the list:

* Exercise your brain. Using it in unusual ways increases blood flow and helps the brain wire new connections. That’s important to build up what’s called cognitive reserve, an ability to adapt to or withstand the damage of Alzheimer’s a little longer.
* In youth, that means good education. Later in life, do puzzles, learn to play chess, take classes.
* Stay socially stimulated. Declining social interaction with age predicts declining cognitive function.
* Exercise your body. Bad memory is linked to heart disease and diabetes because clogged arteries slow blood flow in the brain.
* Experts recommend going for the triple-whammy of something mentally, physically and socially stimulating all at once: Coach your child’s ball team. Take a dance class. Strategize a round of golf.
* Diet’s also important. While Alzheimer’s researchers have long recommended a heart-healthy diet as good for the brain, the folate study is the first to test the advice directly.

The recommended daily dose of folate in the USA is 400 micrograms; doctors advise women of childbearing age to take a supplement to ensure they get that much.

The research findings add to mounting evidence that a diet higher in folate is important for a variety of diseases. Scientists have long thought that folate might play a role in dementia, and previous studies have shown people with low folate levels are more at risk for both heart disease and diminished cognitive function.

For more information: www.hsfolate.com

Veggies halt mental decline

Chicago: Vegetables help fight mental decline, says a new report that investigated the eating habits of 2,000 men and women in the Chicago area.

On measures of mental sharpness, older people who ate more than two servings of vegetables daily appeared about five years younger at the end of the six-year study than those who ate few or no vegetables.

The research adds to mounting evidence pointing in that direction. The findings also echo previous research in women only.
Leafy Greens

Green leafy vegetables including spinach, kale and collards appeared to be the most beneficial. The researchers said that may be because they contain healthy amounts of vitamin E, an antioxidant that is believed to help fight chemicals produced by the body that can damage cells.

Vegetables generally contain more vitamin E than fruits, which were not linked with slowed mental decline in the study. Vegetables also are often eaten with healthy fats such as salad oils, which help the body absorb vitamin E and other antioxidants, said lead author Martha Clare Morris, a researcher at the Rush Institute for Healthy Aging at Chicago’s Rush University Medical Center.

The fats from healthy oils can help keep cholesterol low and arteries clear, which both contribute to brain health.

The study was published in this week’s issue of the journal Neurology and funded with grants from the National Institute on Aging.

“This is a sound paper and contributes to our understanding of cognitive decline,” said Dr. Meir Stampfer of Harvard’s School of Public Health.

“The findings specific for vegetables and not fruit add further credibility that this is not simply a marker of a more healthful lifestyle,” said Stampfer, who was not involved in the research.
Mental Function

The research involved 1,946 people aged 65 and older who filled out questionnaires about their eating habits. A vegetable serving equaled about a half-cup chopped or one cup if the vegetable was a raw leafy green like spinach.

They also had mental function tests three times over about six years; about 60 percent of the study volunteers were black.

The tests included measures of short-term and delayed memory, which asked these older people to recall elements of a story that had just been read to them. The participants also were given a flashcard-like exercise using symbols and numbers.

Overall, people did gradually worse on these tests over time, but those who ate more than two vegetable servings a day had about 40 percent less mental decline than those who ate few or no vegetables. Their test results resembled what would be expected in people about five years younger, Morris said.
Physically Active

The study also found that people who ate lots of vegetables were more physically active, adding to evidence that “what’s good for your heart is good for your brain,” said neuroscientist Maria Carillo, director of medical and scientific relations for the Alzheimer’s Association.

The study examined mental decline but did not look at whether any of the study volunteers developed Alzheimer’s disease

Happiness poll reveals that Briton’s less happy than 50 years ago

London: Briton’s may be better off financiall but they are less happy, according to poll carried out for the BBC.

It found that although Britain is three times richer than it was 50 years ago, the country is not as happy as it was then. In 1957, 52% of the people said they were ¬Ďreally happy’ but only 36% said they were, according to the BBC Two TV programme called The Happiness Formula.

In common with the US, the UK is reporting lower levels of personal happiness. A General Social Survey recently found that 34% of Americans were ¬Ďvery happy’ in the 1970s. By the end of the 1990s the figure dropped to 30%.

Polls over the last few decades seem to indicate that as soon as average incomes reach about £10,000 annually ($18,000), any further income increases do not bring about more happiness.

It seems there are many countries whose levels of happiness are higher than Britain’s.

When British people were recently asked whether governments should aim more for making a country happier or wealthier, 81% opted for happiness while only 13% opted for wealth. 52% of British people polled believe schools should focus more on teaching children how to achieve happiness in their personal lives.

43% of British people think that where they live is less friendly than it used to be, 22% think it is more friendly.Only 7.7% of 1000 people interviewed thought work fulfillment was the most important contributory factor towards happiness. Most people place relationships as the largest factor, followed by health.