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Home > Research Articles > Survey Shows Two-thirds of Europeans, North Americans Still Associate Dementia with 'Aging Process'

Canada NewsWire via COMTEX

Sunday, July 21, 2002

Survey Shows Two-thirds of Europeans, North Americans Still Associate Dementia with 'Aging Process'-International Survey Reveals Need for Better Understanding of Dementia Among Both General Practitioners And Public

Canada NewsWire - July 19, 2002 STOCKHOLM, Sweden, Jul 19, 2002 (Canada NewsWire via COMTEX) -- A new survey announced today in conjunction with the 8th International Conference on Alzheimer's Disease and Related Disorders found that overall, 65 percent of adults in the United States, Canada and the major European countries believe that the "aging process" can cause or contribute to the development of dementia. However, while it is true that the risk of developing dementia doubles every five years after the age of 65(1), Alzheimer's disease and other forms of the disorder are not a natural consequence of aging.Survey Shows Two-thirds of Europeans, North Americans Still Associate Dementia with 'Aging Process'-International Survey Reveals Need for Better Understanding of Dementia Among Both General Practitioners And Public Canada NewsWire - July 19, 2002

Likewise, more than half (57 percent) of adults in these countries are unaware that cerebrovascular disease, manifested as one or more strokes, can cause dementia. In fact, it is estimated that of the 18 million(2) to 37 million(3) people worldwide who suffer from dementia, stroke is a primary or secondary factor in one out of every four(4).

The survey was conducted among 1,000 adult members of the general public in the United States, Canada, the United Kingdom, France, Germany, Italy and Spain by NOP Healthcare, an arm of NOP World (a global market-research consultancy). In addition to the general public, NOP World researched beliefs and practices related to dementia among general practitioners (GPs) - 100 in each of the European countries, 111 in Canada and 150 in the United States. Funding came from the Janssen "family" of companies (Janssen-Cilag in the EU, Janssen Pharmaceutica Products, LP in the United States and Janssen-Ortho in Canada), which market Reminyl(r) (galantamine), a medication approved for the treatment of mild to moderate Alzheimer's disease. Expert consultation on the survey questions and interpretation of the findings was provided by Alzheimer's Disease International, a not-for-profit association that works around the world to promote enhanced education and treatment for people with dementia.

"This survey reinforces the continuing need for education, among both the general public and the medical community, on many aspects of dementia - including its risk factors and available treatments," noted Elizabeth Rimmer, executive director for Alzheimer's Disease International (ADI; www.alz.co.uk). "We're pleased that the majority of general practitioners surveyed (66 percent overall) are aware of the existence of organisations in their countries that provide support and education on Alzheimer's disease and other forms of dementia. However, it is clear that we -- and our affiliated groups -- can offer so much more help than is being sought. We hope that, among the many services we offer, the educational campaign we are planning around World Alzheimer's Day on Sept. 21 will begin to improve this situation. The theme is 'Old age or disease?: recognising dementia,' and this survey shows we've chosen the right focus for our outreach."

The survey found that 60 percent of GPs across the regions surveyed said they routinely screen their elderly patients for signs of dementia - compared to much higher percentages for other common disorders among the aging (93 percent said they routinely screen for cardiovascular disease, 83 percent screen for prostate cancer in men, 80 percent assess for breast cancer in women and 75 percent look for osteoporosis). As evidence of the continuing debate in the medical community over whether routine dementia screening should be conducted among the elderly, the percent of GPs reporting this practice ranged from a low of 21 percent in the United Kingdom and 50 percent in France to a high of 76 percent in Canada and 77 percent in the United States.

When asked specifically about their elderly patients who had experienced one or more strokes, the percentage of PCPs worldwide who say they routinely screen for dementia increased. Strokes can cause vascular dementia -- the second-most-common type of the disease. However, most GPs under-estimated the risk of dementia in stroke victims. Although there is evidence that about half of these individuals will develop dementia within five years of their stroke(5), only 16 percent of GPs across the regions estimated an occurrence rate of this magnitude. This under-estimation was generally common among all of the countries surveyed.

When asked whether they believed that medications were available today that could safely and effectively treat patients in whom dementia that is caused or exacerbated by stroke, about half of GPs overall said "yes" - ranging from a low of 18 percent in Spain and 29 percent in Italy, to a high of 71 percent in Germany and 69 percent in the United States. Among those who are aware of treatments that can be used for these patients, most cited medications such as cholesterol reducers, antihypertensives and anticoagulants - drugs that can prevent strokes, but for which there is no evidence they can treat the symptoms of dementia.

Sixty-seven percent of these GPs - but as few as 44 percent in Spain and 49 percent in the UK - said they thought cholinesterase inhibitors (medications commonly used to treat Alzheimer's disease) can be safe and effective in treating patients whose dementia is caused or complicated by stroke. However, although none of these medications has yet been approved to treat vascular dementia, there is an increasing body of scientific data indicating that at least some of them are effective in slowing progression of symptoms in patients with that form of the illness as well. A report published in the April 13 Lancet suggested that Reminyl is effective in treating dementia symptoms in individuals with cerebrovascular disease.

Reminyl inhibits an enzyme that breaks down acetylcholine -- a 'neurotransmitter' in the brain that plays a key role in memory and learning. In addition, Reminyl modulates the brain's nicotinic receptors, to which acetylcholine binds. Laboratory research suggests that this causes more acetylcholine to be released, as well as increases the receptors' sensitivity to the neurotransmitter.

When used in accordance with the recommended dosing schedule, the most common side effects of Reminyl are primarily gastrointestinal in nature (nausea, vomiting and diarrhea). These side effects -- if they occur -- tend to happen when starting the medication or increasing the dosage, and are usually mild and temporary.

Reminyl was developed by Johnson & Johnson Pharmaceutical Research & Development (J&JPRD)under a co-development and licensing agreement with UK- based Shire Pharmaceuticals Group plc. Reminyl is marketed by Janssen Pharmaceutica Products and Ortho-McNeil Pharmaceutical in the United States, Janssen-Ortho in Canada and Janssen-Cilag elsewhere - with the exception of the United Kingdom and Ireland, where it is registered and marketed by Shire under a co-promotion agreement with Janssen-Cilag. The product is approved for the treatment of mild to moderate Alzheimer's disease in 30 countries, and also is being studied in individuals with vascular dementia and mild cognitive impairment (believed to be a precursor to Alzheimer's disease). More information on the product can be found on www.reminyl.com.

J&JPRD supported this analysis and collaborated with the authors on study design, collection of data and interpretation of findings.

Janssen Pharmaceutica Products, Ortho-McNeil Pharmaceutical, Janssen- Ortho and Janssen-Cilag are wholly owned subsidiaries of Johnson & Johnson (NYSE: JNJ). They have a long track record in developing and marketing treatments for central nervous system disorders.

Shire Pharmaceuticals Group, plc, is an international specialty pharmaceutical company with a strategic focus on four therapeutic areas: central nervous system disorders, metabolic diseases, oncology and gastroenterology. The group has a sales-and-marketing infrastructure, with a broad portfolio of products, and its own direct-marketing capability in the United States, Canada, UK, Republic of Ireland, France, Germany, Italy and Spain, with plans to add Japan by 2004. On Dec. 11, Shire entered into an agreement to merge with BioChem Pharma Inc. to form a leading global specialty pharmaceutical company.

References 1. Jorm AF, Korten AE, Henderson AS. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatrica Scandinavica 1987; 76: 465-479. 2. World Alzheimer's Day bulletin, Alzheimer's Disease International, 1997 3. World Health Report 2002, World Health Organisation 4. Neurology in Clinical Practice, 3rd Edition, Bradley WG, Daroff RB,et al, pg 1721 5. Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB. "Progression of impairment in patients with vascular cognitive impairment without dementia." Neurology, 2001 Aug 28; 57(4):714-6 VIEW ADDITIONAL COMPANY-SPECIFIC INFORMATION: http://www.newswire.ca/cgi-bin/inquiry.cgi?OKEY=66252 CONTACT: For further information: Brigitte Byl, Director, Global Pharmaceutical Communications, Janssen Cilag, T: +32 1460 5910, E: bbyl(at)gpcbe.jnj.com or Elizabeth Park, Ketchum, T: +44 20 7611 3624, E: elizabeth.park(at)ketchum.com Copyright (C) 2002 CNW, All Rights Reserved