Hershey, Pa. -- A new study from Penn State's College of Medicine finds that when medication for Alzheimer's disease is offered to all patients, family members of patients in the early stages of Alzheimer's are the most likely to accept available treatment.
"When dealing with this terrible disease, families are faced with many extremely difficult decisions. One of those decisions is whether or not to treat their ill family member with this relatively new drug, that doesn't stop the disease, but slows the progression of the disease," says Paul Kettl, M.D., associate professor of psychiatry and acting chair of psychiatry at Penn State. Kettl is also chief of psychiatry with the Penn State Geisinger Health System in Hershey, Pa.
The results of the one-year study titled, "Family Treatment Decisions in Alzheimer's Disease," was presented today (June 3) at the American Psychiatric Association meeting in Toronto.
Kettl studied 60 patients with Alzheimer's disease who were admitted consecutively to the inpatient psychiatry unit at Hershey Medical Center. The one-year study asked families whether or not they wanted the patient to be treated with the drug donepezil or vitamin E. Both treatments do not stop the disease but significantly slow the progress of the disease. Donepezil has been widely prescribed by physicians for about a year.
"There were 28 people in the treatment group and 32 people in the non-treatment group. We found there was no difference based on age or sex," says Kettl. "The difference in treatment decisions was determined more by how far the disease had progressed. For patients who were in the early stages of the disease and often were cared for at home, families overwhelmingly chose to treat the patient. For those patients who lived in a nursing home and the disease was fairly advanced, families chose to withhold the treatment."
Kettl says these kinds of difficult ethical questions will have to be faced by more and more families as additional drug therapies become available. "Donepezil is a very good treatment for some patients. We believe the family and the physician working together need to make treatment decisions, not just the physician dictating the course of treatment," he says.
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