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IN YOUR PRIME
Drugs?
Q. A woman-friend tells me she read recently that of all the drugs used to treat Alzheimer’s (ital.) none (end ital.) works.
Is that true? And, if it is accurate why do we pay so much for them?
A. Almost nothing about Alzheimer’s is uncomplicated or comforting.
The disease, which has neither known cause nor proven cure, is best characterized as a sharp and relentless unraveling of the
mind. Alzheimer’s also is the fourth leading cause of death in the United States.
“We estimate a man by how much he remembers,” wrote Ralph Waldo Emerson, who once could recite most of Wordsmith’s poems to
his children as they walked together. Later, Emerson fell victim to Alzheimer’s, as did former President Ronald Reagan, the
alluring Rita Hayworth, painter William de Kooning and actor/advocate Charlton Heston.
Presently, 4.5 million Americans have Alzheimer’s. Moreover, a Gallup poll some years back found one in three Americans knows
someone who suffers with Alzheimer’s, even as 50 percent of the nation worries about becoming a victim.
Now, to address the reader’s questions: at an April medical meeting there was an uncommon disagreement over the effectiveness
of the drugs approved to treat mild-to-moderate Alzheimer’s.
On one side were the so-called medicators, doctors and other health professionals defending the four drugs: Aricept, Exelon,
Reminyl and Tacrine, all of which raise levels of a chemical (acetylcholine) that transmits nerve signals to the brain.
(Note: a fifth drug, Namenda, was approved last year for moderate-severe Alzheimer’s cases.)
Opposing, and questioning, at this underreported session at Johns Hopkins University, Baltimore, was a small group who ask,
“What good are we truly accomplishing?” And, significantly, are the drugs we’re prescribing worth the money? (Facts: each of
the four costs around $120 per month, or $1,440 a year. A current estimate says one million patients use an Alzheimer’s drug,
resulting in an annual United States market of some $1.2 billion.)
One speaker, Dr. Thomas Finucane, Johns Hopkins geriatrician and professor, roused the group when he likened Alzheimer’s to
“a slow motion disaster.” “It’s very hard to sit by and watch,” he continued. “There is an overwhelming desire to do
something, even if it’s to give a useless pill every day.”
Professor Finucane contends millions of dollars are wasted on medicines of little or no efficacy. “In my opinion, we’ll be
embarrassed in 10 years by how much of this stuff we prescribed, ” he concluded.
When a doctor in the audience accused the expert panel of ducking the question about whether to prescribe the available
drugs, there was loud, spontaneous applause.
The responses then ranged from yes, prescribe, but on a trial basis to there’s a one-in-10 chance of some memory
improvement—or a delay in the progress of the Alzheimer’s. Summing up, the moderator turned sober, even grave:
“For us to tell you what to do,” he began, “I think would be wrong. All you can do is look at your soul, and do the best you
can.”
A strong defense of the drugs came later from Janet B. Walsh, founder of the Long Island (NY) Alzheimer’s Foundation and
herself a patient diagnosed with early-onset Alzheimer’s. In a published letter, she writes: “For some patients who take
these drugs…the stalling of the decline has been truly remarkable.”
On the subject of a cure, or some dramatic drug to forestall the disease, this column holds to, “Sorry, not anytime soon.”
However, consider this observation from “The Forgetting,” author David Shenk’s 2001 work that earlier this year became a
television documentary.
Between one and two million lives have been saved in the 50 years since Jonas Salk and Albert Sabin introduced their polio
vaccines, explains Shenk. He writes next, “Curing Alzheimer’s sometime in the first decade of the 21st century would save as
many as 100 million lives worldwide in the same length of time.”
Clearly, humankind has no alternative but to make the greatest of research efforts, and to succeed…American scientists must
break through!
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Outrageous Associations
