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Cognitive Stimulation in Combination With Drug Slows Decline in Alzheimers Patients, Study Shows

Journal of Speech, Language, and Hearing Research Publishes
Paper by U. T. Dallas, UT Southwestern Medical Center Scientists

Richardson, Texas (Oct. 21, 2004)
A program of active cognitive stimulation performed in conjunction with the drug Aricept (donepezil hydrochloride) produces greater mental and functional benefits in patients in the early stages of Alzheimers disease than taking the drug alone, according to a study conducted by Texas university researchers and funded by the manufacturer and U.S. distributor of the drug.

The study, the results of which are published in the October issue of the Journal of Speech, Language, and Hearing Research, was conducted by researchers at two Dallas-area component institutions of The University of Texas System The University of Texas at Dallas (UTD) and The University of Texas Southwestern Medical Center at Dallas (UT Southwestern). The results add to growing evidence that active cognitive stimulation may slow the rate of verbal and functional decline and decrease negative emotional symptoms in Alzheimers patients when combined with an acetylcholinesterase inhibitor like Aricept.

UTDs portion of the research was conducted by scientists from the Center for BrainHealth, part of the universitys School of Behavioral and Brain Sciences.

The study was funded by Eisai Co., Ltd., the Tokyo-based pharmaceutical company that manufactures Aricept, and Pfizer, Inc., of New York, the U.S. distributor of the drug.

Fifty-four patients with mild to moderate Alzheimers disease, ranging in age from 54 to 91, took part in the randomized study. Twenty-eight of the patients received Aricept only, while 26 were given the drug and took part in a cognitive stimulation program consisting of 12 hours of intervention treatment by speech-language pathologists over an eight-week period at the beginning of the one-year study. The stimulation program consisted of participant-led discussions requiring homework, reading and discussion on Alzheimers treatment and composition of written life stories. Evaluations of the patients were conducted at the end of the fourth, eighth and 12th month.

According to the study, the Aricept-plus-stimulation group showed a slower rate of decline than patients taking Aricept alone. Specifically, the following benefits were noted:

  • Slower rate of disease progression, as measured by a widely used screening method.
     
  • Reduction in emotional symptoms of irritability and apathy.
     
  • Maintenance of meaningful verbal communication.
     
  • Improvement in patient-reported quality of life.
     
  • Slower decline in functional abilities.

"For decades, attention has been drawn to the brains incredible ability to adapt after stroke and traumatic brain injury, said Sandra Bond Chapman, Ph.D., director of the UTD Center for BrainHealth and leader of the study team. Only recently has the concept called plasticity been applied to progressive brain diseases such as Alzheimers. The UTDUT Southwestern study supports the idea that it is possible to stimulate the brain to halt or slow the progression of early-stage Alzheimers disease.

Alzheimers is a complex disease that causes the gradual loss of brain cells, making it difficult for those who suffer from it to remember, reason and use language. Approximately 4.5 million Americans have the disease. Although many things about Alzheimers remain a mystery, research continues to yield a better understanding of the disease, more accurate diagnoses and more effective treatments.

The disease is more common in older adults. About one in 10 people over the age of 65 have Alzheimers. As many as five in 10 people over the age of 85 have the disease.

The disease was first described in 1906 by German physician Dr. Alois Alzheimer. Although the disease was once considered rare, research has shown that it is the leading cause of dementia.

Besides Chapman, members of the study team included three other speech-language pathology researchers two from UTD, Audette Rackley, M.S., and Jennifer Zientz, M.S., and one from UT Southwestern, Linda S. Hynan, Ph.D. and a physician, Myron F. Weiner, M.D., from UT Southwestern.

Copies of the groups paper, Effects of Cognitive Communication Stimulation for Alzheimers Disease Patients Treated with Donepezil, are available by contacting Rene Hockaday of the American Speech-Language-Hearing Association, publisher of the Journal of Speech, Language, and Hearing Research, at (301) 897-7351or rhockaday@asha.org.

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