Alzheimer's: An Investigation into Treatment Options Dana McGuire and Jessica Scharfenberg MPH 543:...
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Alzheimer's: An Investigation into
Treatment Options
Dana McGuire and Jessica Scharfenberg
MPH 543: Leadership and Organizational Management
Concordia University
June 2015
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What is Alzheimer’s Disease?
It is the most common cause of dementia and a primary progressive degenerative disease of nerve cells in the brain.
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Risk Factors
• Age
• Family History
• Genetics
• Sex
• Past history of head trauma
• Heart Health
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Disease Progression
• Mild (Early Stage)
• Moderate (Middle Stage)
• Severe (Late Stage)
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Mild (Early Stage) Alzheimer’s
• Function Independently but feel they have memory lapses
• Word searching-Unable to come up with the right word or name
• Difficulty performing tasks in social settings
• Losing or misplacing objects
• Trouble with planning and organizing
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Moderate (Middle Stage) Alzheimer’s
• Forgetfulness of one’s personal history
• Withdrawal from social situations
• Troubles with bladder and bowel control
• Wandering
• Changes in sleep pattern
• Delusions and compulsiveness
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Severe (Late Stage) Alzheimer’s
• 24 hour care is needed
• Loss of awareness to surroundings
• Assistance of all daily activities including eating, grooming, and bathing
• Difficulties communicating
• Increasing vulnerability to infections
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Direct Costs
• $172 billion each year (indirect and direct)
• Hospitalizations
• Nursing Homes/Groups Homes for 24 hour care
• Accidents
• Medical Bills
• Research
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Indirect Costs
• Mental anguish of family members
• Depression
• Setting up a safe environment
• Absenteeism
• Lost productivity
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Current Treatment Options
Cholinesterase Inhibitors- inhibit the breakdown of Acetylcholine and prevents the destruction of nerve cells.
• Donepezil (Aricept)
• Rivastigmine (Exelon)
• Galantamine (Razadyne)
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Donepezil (Aricept)Benefits• Highly Specific Reversible Inhibitor• Use for all stages of disease• Taken once daily
Side Effects• Nausea• Vomiting• Diarrhea
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Rivastigmine (Exelon)Benefits
• Mild to Moderate Stages• Pill, syrup, or skin patch• As good as Aricept• Can block activity of other enzymes
Side Effects• Nausea• Vomiting• Diarrhea• Weightloss
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Galantamine (Razadyne)Benefits
• Used for mild/moderate Alzheimer’s• Proven to slow cognitive decline in patients for up to 36
months• Stimulates release of Acetylcholine
Side Effects• Nausea• Vomiting• Rare cardiac events in some patients
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Why Fund these Treatments?
• They are temporary, but have shown improvement for past patients.
• Proven to lessen severity of symptoms.
• Treat symptoms of memory loss, reasoning, language, and thinking.
• Use for patients in mild to moderate stages.
• Keeps hospitalizations down.
• More aware and productive.
• Better family dynamic.
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ReferencesAlzheimer's Association. (2012, January). FDA-Approved Treatments for Alzheimer's. Retrieved from
https://www.alz.org/national/documents/topicsheet_treatments.pdf
Alzheimer’s Association. (2015a). Risk factors. Retrieved from
http://www.alz.org/alzheimers_disease_causes_risk_factors.asp
Alzheimer’s Association. (2015b). Stages of Alzheimer’s. Retrieved from
http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp#overview
Auriacombe, S., Pere, J., Loria-Kanza, Y., & Vellas, B. (2002). Efficacy and Safety of Rivastigmine in Patients with Alzheimer's Disease
who Failed to Benefit from Treatment with Donepezil. Current Medical Research and Opinion, 18(3), 129-138. Retrieved from
http://informahealthcare.com/doi/abs/10.1185/030079902125000471
Birks, J. (2006). Cholinesterase inhibitors for Alzheimer's Disease. Cochrane Database System Review, 1. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/16437532
Birks, J., & Melzer, D. (2003). Donepezil for mild and moderate Alzheimer's disease. The Cochrane Database of Systematic Reviews.
doi:10.1002/14651858.CD001190
Mayeux, R., & Sano, M. (1988). Treatment of Alzheimer's disease. The New England Journal of Medicine, 662(1), 17-18.
doi:10.1007/bf03309184
Mayo Clinic. (2014). Alzheimer’s disease. Retrieved from http://www.mayoclinic.org/diseases-
conditions/alzheimers-disease/basics/risk-factors/CON-20023871
Mayo Clinic. (2014a, July 11). Alzheimer's: Drugs helps manage symptoms. Retrieved from
http%3A%2F%2Fwww.mayoclinic.org%2Fdiseases-conditions%2Falzheimers-disease%2Fin-depth%2Falzheimers%2Fart-20048103
National Center for Policy Analysis. (2007). Cost of Alzheimer’s care to rise. Retrieved from
http://www.ncpa.org/sub/dpd/index.php?Article_ID=14331