aricept

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Cvd
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aricept

Post by Cvd »

Hi all, I came across this Nature article about Acetyl‑cholinesterase‑inhibitors, and have pasted the abstract below.
The article says that for those with very mild Alzheimers (MMSE about 28), aricept kept MMSE scores stable for almost 6 years. This sounds to me like a convincing reason to start taking aricept at the early MCI stage. Wondering if anyone has an opinion on this? Thank you.

https://www.nature.com/articles/s41598-022-16476-w.pdf

We evaluated the effect of Acetyl-cholinesterase-inhibitors (AChEIs) on cognitive decline and overall
survival in a large sample of older patients with late onset Alzheimer’s disease (LOAD), vascular
dementia (VD) or Lewy body disease (LBD) from a real world setting. Patients with dementia
enrolled between 2005 and 2020 by the "Alzheimer’s Disease Research Centers" were analyzed; the
mean follow-up period was 7.9 years. A 1:1 propensity score matching was performed generating
a cohort of 1.572 patients (786 treated [AChEIs +] and 786 not treated [AChEIs-] with AChEIs. The
MMSE score was almost stable during the frst 6 years of follow up in AChEIs + and then declined,
while in AChEIs− it progressively declined so that at the end of follow-up (13.6 years) the average
decrease in MMSE was 10.8 points in AChEIs- compared with 5.4 points in AChEIs+ (p < 0.001). This
trend was driven by LOAD (Δ-MMSE:−10.8 vs. −5.7 points; p < 0.001), although a similar effect was
observed in VD (Δ-MMSE:−11.6 vs. −8.8; p < 0.001). No effect on cognitive status was found in LBD.
At multivariate Cox regression analysis (adjusted for age, gender, dependency level and depression)
a strong association between AChEIs therapy and lower all-cause mortality was observed (H.R.:0.59;
95%CI: 0.53–0.66); this was confirmed also in analyses separately conducted in LOAD, VD and LBD.
Among older people with dementia, treatment with AChEIs was associated with a slower cognitive
decline and with reduced mortality, after a mean follow-up of almost eight years. Our data support the
effectiveness of AChEIs in older patients affected by these types of dementia.
TLS
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Re: aricept

Post by TLS »

I know of two people in my personal life who have been diagnosed with MCI and have benefited from taking one of the medicines.
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TheresaB
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Re: aricept

Post by TheresaB »

Cvd wrote: Thu Oct 27, 2022 4:46 pm The article says that for those with very mild Alzheimers (MMSE about 28), aricept kept MMSE scores stable for almost 6 years. This sounds to me like a convincing reason to start taking aricept at the early MCI stage. Wondering if anyone has an opinion on this? Thank you.
That does seem to present an enticing argument to start taking Aricept at the early MCI stage. But in my opinion, there are better choices. My thoughts:

• MMSE is a helpful tool, but has limitations. It is a 30-point questionnaire that only takes between 5 and 10 minutes. From Mini-Mental State Examination the most frequently noted disadvantage of the MMSE relates to its lack of sensitivity to mild cognitive impairment and its failure to adequately discriminate patients with mild Alzheimer's disease from normal patients.

• Not everyone can take Aricept, there are conditions which prohibit its use.

• Aricept comes with side effects.

• Is Aricept the only prescription drug to be taken? Studies suggest that taking multiple prescription drugs (polypharmacy) is associated with an increased risk of dementia Taking multiple medications may increase risk of dementia, research shows

• The primary focus of pharmaceutical drugs is on treating symptoms of illness and disease, not actual recovery of health. Drugs do not get at the root cause of disease, it is reactionary. There are multiple causes of cognitive issues, Aricept can’t address them all. For example, if a person’s lifestyle practices are disrupting their Circadian Rhythm and that’s what causing cognitive issues, the Aricept may slow the decline, but it won’t address the root cause, whereas there are practices that can be followed to better honor one’s natural body rhythms (see Circadian Rhythm). Same with diet, toxic exposures, body stressors, etc.

Are you familiar with the Bredesen Protocol? You can read about in in our ApoE4.info wiki and specifically about the clinical trial results here: Bredesen Protocol Clinical Trial Results] I took this graphic from that link and you can see Dr Bredesen’s Recode protocol, which is largely diet/lifestyle based, performs substantially better than the recently introduced Alzheimer’s drugs.
Change in Cognitive Performancd.jpg
My personal opinion is that given the current state of Alzheimer’s drug development, that drugs should be administered only if disease progression makes it necessary for the sake of the patient and caregivers. Being mindful of diet, sleep, stress, exercise and toxin exposures typically doesn’t come with side-effects. Early MCI means a person still has the wherewithal to follow such lifestyle choices that can have long lasting, positive effects.
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-Theresa
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TLS
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Re: aricept

Post by TLS »

I very much agree with Theresa and was a little too brief in my earlier comment. I myself am following the natural solutions as best as I can and believe that will prevent me from getting the disease. For those people who refuse to try the protocol (that is the example I have) experimenting with medicine (in this case galantamine) and including as much of the supplements as I can get her to take, has made a difference.
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Re: aricept

Post by circular »

TheresaB wrote: Sun Nov 20, 2022 7:29 am MMSE is a helpful tool, but has limitations. It is a 30-point questionnaire that only takes between 5 and 10 minutes. From Mini-Mental State Examination the most frequently noted disadvantage of the MMSE relates to its lack of sensitivity to mild cognitive impairment and its failure to adequately discriminate patients with mild Alzheimer's disease from normal patients.
I'm no expert in these things and not digging deeply into it, but I actually wonder why a paper using the MMSE as a standard to evaluate decline made it into Nature. It may have been the only tool the researchers could use for some reason, but if the statisticians couldn't/didn't adjust for its limitations (???), then I agree with TheresaB that this study is not inspiring.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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