Researching the Prevention of Dementia
- July 2007
- Français
Without a great team effort the dementia research study would not be possible. Members of the Robert Bell & Gladys May Bell Memorial Foundation (in no particular order) are Louis and Stella Ziff (pictured seated), Margaret Sisler, Linda Ressler, Gerry Chapman, Carrie Kaye. Geriatric Assessment staff are; Wendy McPherson, Carol Colangelo, Shirley Hawkey, Rosemary Panetta, Christine Lam Au. Geriatric Assessment Program volunteer is Edith McLeod. Physician Leaders are Dr. Willie Molloy and Dr. David Cowan.
When the discussion begins about a new research study to help patients with dementia, Dr. Willie Molloy, Geriatrician, becomes even more animated than usual. "We're talking about research that could provide a major breakthrough in determining how to stave off Alzheimers and could also help people suffering from Multiple Sclerosis, ALS and Parkinsons," Dr. Molloy says. "The best part is its happening right here in Niagara."
Dr. Molloy is referring to a research study that began in January/07 with patients visiting the Geriatric Assessment Program at the Niagara Health System's Greater Niagara General Site (GNG) in Niagara Falls. Over the next few years, 100 Niagara patients will be recruited to take part in the study, along with 400 other patients in Hamilton, Toronto, St. John (New Brunswick), Halifax, London, Peterborough, Simcoe and Kitchener. Dr. Molloy is leading the research study from St. Peter's Hospital in Hamilton. "We will complete the four year trial and then we publish our results. If the results show what we hope, patients could start benefiting from a new way to treat dementia by 2011."
The study has received significant funding from the Robert Bell and Gladys May Bell Memorial Foundation, a Niagara-based foundation providing support for Alzheimers patients and families. "We are very pleased to be helping patients through this study," says Foundation Board member Margaret Sislar. "There is great potential and we're excited to be part of it."
Study participants are patients who already have dementia in varying stages, many with Alzheimers disease. The study is testing two antibiotic drugs, Doxycycline – used to treat acne, and Rifampin – used in the treatment of tuberculosis and leprosy. A previous small-scale study conducted by Dr. Molloy and his team a few years ago with the antibiotics showed surprising results, indicating that more detailed research is needed. "What we found was that the drugs were able to slow the progress of dementia – that is, the patients' level of dementia did not worsen, as it normally would."
This time around, a thorough study of each patient for one year is taking place. Christine Lam-Au, RN, is the Study Co-ordinator at GNG. "Once the patient and his/her family member or caregiver has agreed to participate, we carry out a two-hour assessment by conducting memory tests, assess their ability to carry out activities of daily living (washing, dressing, toileting), assess mood and behaviours, and measure a wide range of other elements that are symptoms of dementia," Christine explains. "Blood work is carried out, a CT is done and in addition, cerebral spinal fluid is taken." Reviewing spinal fluid is not normal procedure for most patients, but because the research study is looking at how the drugs work in the brain, a before and after study of spinal fluid is helpful.
The patients are participating in what is called a double blind study. They are given combinations of the two antibiotics being reviewed or two placebos which will have no effect. "We're providing the medications and the placebos in four combinations, to ensure we have strong data to measure the patients' progress," says Dr. Molloy. "The beauty of using Doxycycline and Rifampim is that these antibiotics have been around for almost 50 years, and the medical community is very knowledgable about how they work in the system. These are typically prescribed for long-term use, up to two years, and we know there are no harmful side effects. Another huge benefit is that these are generic drugs and are therefore fairly inexpensive."
Once the patients have started on the medications, they come back to the Geriatric Assessment clinic every three months for a follow-up assessment and more blood work.
Dr. David Cowan is the lead Geriatrician for the Geriatric Assessment Program at GNG. "The staff here is very supportive of the research study and so far, 24 Niagara patients have enrolled. The average age of our patients is about 80, and for the caregivers, participation in the study takes real commitment. They have to ensure the patients are taking their meds and that they come in for their three-month appointments for one year, so it can be a large undertaking."
Both Dr. Molloy and Dr. Cowan, whose practices focus on the elderly, know just how great the impact of someone with dementia is on a family. "Certainly, cancer and heart disease touch many of our family members, but so does dementia," says Dr. Cowan. "The angst of seeing a loved one declining with dementia, when they should be reflecting on a long life and knowing and enjoying their family, is heartbreaking. We are very hopeful that this study will actually make a difference for many of our patients."