How Much do Dementia Treatments Help?

Dementia treatments helped with symptoms but they did not improve quality of life

(RxWiki News) Treatments for dementia target symptoms. Many help improve memory and thinking. But does improving symptoms lead to better quality of life?

Researchers reviewed all the published trials on dementia medicines and nutrition supplements. They found that many trials didn’t even ask about quality of life. For the trials that did, none of the treatments were linked with improved quality of life or well-being for the patients.

The authors suggested that all trials on dementia treatment need to ask about quality of life because improved symptoms do not necessarily equal better daily function and well-being.

"Ask a doctor which dementia treatments are right for you."

The study authors, led by Claudia Cooper, PhD, of the Department of Mental Health Sciences at University College in London, found 16 published papers that reported quality of life for people using a variety of dementia treatments.

The researchers reviewed the trials that used some measure of quality of life, well-being, happiness or pleasure. They looked at the data of these trials to see if any drugs improved quality of life by the end of the trial.

The review included trials involving medicines specifically for dementia and other symptom treatments like non-steroidal anti-inflammatory drugs (NSAIDs), antipsychotic medicines, gingko biloba extract and nutritional supplement drinks.

One study looked at the NSAID pain relievers rofecoxib (Vioxx) and naproxen (Aleve) for people with Alzheimer’s disease. After one year of taking one of these medicines, quality of life was not better.

The one study looking at an experimental NSAID, called tarenflurbil, found that people with mild Alzheimer's did not report improved quality of life after 18 months.

Quality of life was measured in five studies involving medicines designed to treat Alzheimer's. Neither donepezil (Aricept) nor memantine (Namenda) improved quality of life after 24 weeks of treatment in any of the trials.

Two studies in which patients were taking the antipsychotic olanzapine (Zyprexa) for three months found that quality of life was not better after treatment.

One study included patients taking the antidepressant sertraline (Zoloft). After 24 weeks, these patients did not have improved quality of life.

Three studies used either gingko biloba extract or other nutritional supplements. While these supplements helped with some symptoms, quality of life was not improved for people with Alzheimer's or vascular dementia.

The authors concluded, “We found no consistent evidence that any drug improves quality of life in people with dementia.”

However, few studies measured quality of life or used standard measures, so drawing conclusions from this review is difficult. There were no trials that measured the quality of life among patients taking galantamine (Nivalin) or rivastigmine (Exelon) - two drugs that are approved for treating Alzheimer's.

The authors noted that the results of this review should be interpreted with caution, but more studies need to look at quality of life after treatment.

The authors said, “We recommend that all dementia trials should include quality of life as an outcome, as this is important to patients, and cannot be presumed from improvements in cognition or other symptomatic outcomes, especially if the latter are small.”

This review was published in February in The American Journal of Geriatric Psychiatry. Some of the authors reported financial links to multiple pharmaceutical companies.

Review Date: 
February 11, 2013