Intended for healthcare professionals

Letters Dementia research

No evidence exists that “anti-dementia” drugs modify disease or improve outcome

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2607 (Published 07 April 2014) Cite this as: BMJ 2014;348:g2607
  1. Peter J Gordon, consultant psychiatrist for older adults1
  1. 1Clackmannan Community Healthcare Centre, Sauchie FK10 3JQ, UK
  1. petergordon{at}nhs.net

More than three months have passed since the G8 dementia summit was held in London, allowing time for critical thinking over its most laudable aim to “create disease modifying treatment to try to stop, slow, or reverse the condition.”1 This was less than a year after I gave an interactive talk based on one question: “What do we mean by Alzheimer’s disease?”2

In my talk I presented what evidence told us about currently available “anti-dementia” drugs, that, as yet, there is no conclusive evidence that they modify disease or improve outcome.3

In sharing this evidence with my audience of health professionals, many seemed to exhibit furrowed brows and looked at me as if I were an “outlier.” During and after my talk the evidence I presented was challenged by several of those who attended. These drugs, they confirmed, in their understanding, did modify outcome and that is what they told patients. It was further explained to me, after my presentation, that this was the “prevailing” understanding.

Leading world experts established at the G8 dementia summit that there was no evidence that existing drugs modified disease, and the World Health Organization director-general Margaret Chan summarised this for G8 in the following way, “in terms of a cure, or even a treatment that can modify the disease, we are empty-handed.”4

This story seems to show that my profession was perhaps not following evidence but, rather, wishful thinking and, indeed, mythology. I am left wondering why this happened and why such evidence was not properly shared with patients. It also occurs to me that industry, politicians, and national leads seem to have made little effort to challenge this “prevailing understanding,” at least until the “anti-dementia” drugs had largely come off patent.5 Our patients deserve better. They deserve truth. We all need to do better with that cherished and high ideal of informed consent.

Notes

Cite this as: BMJ 2014;348:g2607

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