Withdrawing dementia drug doubles risk of nursing home placement

University College London (UCL) research shows that withdrawing donepezil from people with advanced stages of Alzheimer’s doubled their risk of being placed in a nursing home within a year

Researchers funded by the Medical Research Council and Alzheimer’s Society followed 295 people with moderate to severe Alzheimer’s disease to monitor the effects of continuing or discontinuing the drug donepezil.

The participants were randomly selected to either continue donepezil or withdraw from the drug by receiving a placebo.

These two groups were then each divided to test the effect of receiving another dementia drug, memantine, or a placebo.

The recent Domino trial, conducted by scientists at UCL, found that withdrawing donepezil doubled the risk of nursing home placement after a year while memantine was not found to have any effect on risk of nursing home placement.

Previous results published from the Domino trial in 2012 were the first to show that continued treatment with donepezil can provide cognitive and functional benefits in people with moderate to severe Alzheimer’s disease, such as retaining the ability to eat, dress and go shopping more independently.

Robert Howard, professor of old age psychiatry at UCL, said: “Our new results show that these benefits translate into a delay in becoming dependant on residential care.

“We are all impatient for the advent of true disease-modifying drugs that can slow or halt the Alzheimer process but donepezil is available right now and at modest cost.”

Dr Kathryn Adcock, head of neurosciences and mental health at the Medical Research Council, said: “This study provides strong evidence that donepezil can benefit people in the more severe stages of Alzheimer’s disease for longer than was expected.“

Dr Doug Brown, director of research and development at the Alzheimer’s Society, said: “These robust findings are of real significance to people with dementia and their families who want to continue living at home for as long as possible.

“We urge clinicians to consider the implications of this research and adjust their prescribing patterns accordingly.”