Caregivers play an essential role in the management of Alzheimer ’ s
build-up in the brain is the only observable hallmark of Alzheimer ’ s . But expensive equipment ( e . g ., machines for positron emission tomography ) and experienced technicians are both needed to obtain brain images that pinpoint amyloid and tau .
Pharmacological treatment can just offer modest benefits Even if experienced doctors can manage to get an accurate diagnosis and have adequate resources , they still have limited therapeutic options at their disposal . Drugs available to treat Alzheimer ’ s can manage symptoms at best , but they can ’ t stop or reverse them . Moreover , they don ’ t work for every patient , and their effect can wear off over time .
The class of drugs called cholinesterase inhibitors , for instance , can support cognitive functions by increasing the amount of the brain chemical acetylcholine , which helps memory , thought , and judgment processes .
“ Two to three decades of experience with cholinesterase inhibitors showed us that the drugs do have an effect on cognition , behaviours , and mood , � explained Dr Karlawish , but the improvements are small and in some patients it ’ s hard to see any benefit .
Since they ’ re also well tolerated and not that costly , he believes they ’ re worth trying but acknowledges the money could also be spent to support patients with caregiving . This is the option pursued by some countries , including France , that don ’ t subsidise the medications because they prefer using the resources to strengthen long-term care services .
A new drug that can reduce amyloid in the brain was approved by the US Food and Drug Administration last year , raising hopes it could lead to unheard-of clinical benefits by slowing the disease progression . Called Aducanumab , it is also the first medication able to target a key Alzheimer ’ s biological marker .
Its approval , however , has sparked controversy among experts because its benefits are modest while the results observed in clinical trials were mixed . An early analysis showed the drug offered no significant improvement while a subsequent one suggested it could slow the loss of cognitive abilities , though such benefits aren ’ t clear-cut . This prompted the �DA to re�uest additional post-approval trials to verify the new drug ’ s e�cacy in helping patients . The price tag of the new medication , however , stands at about US $ 28,200 per year , and patients who take it might
The class of drugs called cholinesterase inhibitors , for instance , can support cognitive functions by increasing the amount of the brain chemical acetylcholine , which helps memory , thought , and judgment processes .
GlobalHealthAsiaPacific . com SEPTEMBER 2022
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