Dementia Presentation Final

8/14/2019 Dementia Presentation Final

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25 th February 2010

- ohit Shrivastav ohit Shrivastav-Sc Drug Development with Bio busine-Sc Drug Development with Bio busine

,revalence cost revalence cost nd likely market of Dementia nd likely market of Dementia

rug Development to Evidence Based Medi


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Overview of the presentation

History Introduction Prevalence Risk factors Prevention Cost of treatment Market of dementia treatment


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History

In 1901, 1 st case of dementia (now knownas Alzheimer) was reported in a 51 yearold woman at Frankfurt asylum named

Mrs. Auguste Deter . 1 st case of dementia was noticed by Dr.

Aloysius "Alois" Alzheimer , a Germanpsychiatrist and neuropathologist .

.Mrs AugusteDeter .Dr " "Aloysius Alois

h e n D e m e n t i a w a s 1 st e p o r t e d ?


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Introduction

h a t i s D e m e n t i a ?

,

, , ,ent aphasia apraxia agnosia and problem solving that interferes with normal activitie

kills including reasoning and judgment are significantly impaired without loss of consciousne Dementia could be Stat ic

due to brain injuryProgressive due to long term decline in mental abili

r ed is po si ng F ac to rs Chronic use of alcohol and chronic sleep deprivatio

,ion in mental illness like depres

sion and psychosis produces symptoms of Delirium which

20-30 % of the Dementia patients suffer from depression and anxiety. Agitation, aggression and delusion also accompany Dementia.

Dementia ers to any condition that causes a loss of brain cells and deterioration of mental functi


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Prevalence As of 2008, there are an estimated 30 million people with

dementia worldwide. By 2050, it is projected that this figure

will increase to over 100 million.

Alzheimer's disease accounts for more than 50% of cases of dementia in Caucasian populations.

There are about 683,597 people with dementia that accounts for1.1% of the entire UK population.

The total number of people with dementia in the UK is forecasted

to increase to 940,110 by 2021 and 1,735,087 by 2051.

Dementia mainly affects older people. However, it can affectyounger people- there are 15,034 people in the UK under theage of 65 who have dementia.

Former US President Ronald Regan suffered from Alzheimers disease and died at the ageof 93 years in 2004.

Singapore Indonesia Malaysia Myanmar Philippines Thailand Viet Nam

No. of peopleaffectedwithDementia

22,000 600,000 60,000 130,000 175,000 250,000 275,000

No. of people affected by dementia in South-eastAsia in 2005


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Adapted from Dementia UK: The Full Report to the Alzheimer'sSociety produced by King's College London and the London School of Economics

sk o f d eve lop in g d em en tia


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Risk factors for Dementia h o g e t s D e m e n t i a ?


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reas o ra n a ec e nDementia


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Treatments t h e r e a n y t r e a t m e n t f o r D e m e n t i a ?

.Two types of treatment for dementia has been described by NICE.1 & .Psychological Behavioural treatment.2 .Medical treatment

&Psychological Behavioural approach has been recommended as best first choice treatment by NICE. ,for people with dementia Stimulation of the brain such as keeping it active through doing

, .crosswords or puzzles is thought to help in slowing down the development of dementia

e al it y o ri en ta ti on ,therapy aims to reorient the person with dementia to time place

RO therapy slows cognitive decline and means that people with dementia can have prolong.arers under the supervision of a health professional It helps to improve depression in people with d

o ry s ti mu la ti on , , , ,uses a variety of measures including lighting relaxing music sounds massage cu, , .es agitation confusion apathy and improves mood in people with dementia.g and conversational activities administered by carers The sessions concentrate on information proce

.vement in memory is not sure Exerc ise for general fitness

&Psychological Behavioural treatment


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e d i c a l t r e a t m e n t o f d e m e n t i a

There is no known treatment available that can reverse the effects of dementia. Treatments are aimed at managing the symptoms of dementia.

Drugs are used to treat cognitive symptoms, behavioural symptoms, depression,anxiety and sleep problems.

l ut am at e b lo ck er s( ) .Memantine brand name Ebixa inhibits glutamate

.Used to treat memory and nerve cell damage

.that work by preventing the breakdown of acetylcholine

), ( ), ( ) & ( )t galanatamine brand name Reminyl tacrine cognex rivastigmine Exelon.pression in people with dementia include tricyclic antidepressants and the SSRIs Antidepressants may

. - - .to treat anxiety in people with dementia Short acting drugs are preferred to long acting drugs Benzo. - , .stages of dementia But there is a risk of side effects such as excessive sedation dizziness Risperid

Medical Treatment


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Prevention

Research has revealed that there are several factors thatcan prevent or delay the onset of dementia in somepeople.

Studies have shown that people who maintain tight controlover their glucose levels have better cognitive functionthan those with poorly controlled diabetes .

Several studies also have suggested that people whoengage in intellectually stimulating activities, such associal interactions, chess, crossword puzzles and playinga musical instrument have significantly lower risk of developing Alzheimer's disease and other forms of dementia.

Other reventive actions include lowerin homoc steine

a n D e m e n t i a b e p r e v e n t e d ?


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Cost associated with dementia

Total treatment of late-onset dementia costs 17.03 billion, oran average of 25,472 per person. Included in this amountis the estimated 690 million in lost income for those carerswho have to give up employment or cut back their workhours. This lost employment means a loss of 123 million intaxes paid to the Exchequer. Receipt of AttendanceAllowance or DLA amounted to around 919 million per

year, increasing to total cost of about 18 billion.

Total expenditure on dementia is projected to increase by 45per cent to 34.6 billion in 2026.

This increase is primarily due to an estimated increase inservice costs for people with dementia of 9.0 billion. Costswill increase by 111 per cent to 47.5 billion if the real payand price effect is taken into account again, primarily dueto the impact of dementia.

The cost of lost employment, currently estimated to be 26.1billion, is projected to increase by 7.7 per cent to 28.1

Proportion of older peoplein receipt of

home care

Proportion of older peoplewho receive

day care

Hourly home care cost

England3.9%

1.7%. 9.20 - 22.10

Scotland 6.9% 1.3%740- 187 per person

per year

Wales 4.3% 1.6% 17.6 NorthernIreland 2.4 % 1.1 %

-

c o n o m i c i m p a c t o f D e m e n t i a


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World Market Worldwide societal cost estimate for dementia of US$315.4 billion.

Drug Market for symptomatic drugs is worth US$50.4 Billion (UnitedStates, France, Germany, Italy, Spain, the United Kingdom, and

Japan accounts for US$ 5.5 Billion) .

The currently used symptomatic drugs are Aricept ($2.5 Bn annually )from Eisai & Pfizer and other two major drug manufacturers in thismarket are Novartis and Johnson & Johnson.

The estimate for total cost of dementia in some countries (direct costsplus informal care) in 2005

Singapore was US$391 million . Indonesia was US$2,128 million ;Malaysia was US$511 million Myanmar was US$118 million ;Philippines was US$601 million Thailand was US$1,330 million ;Viet Nam was US$751 million .

r u g m a k e r s p r o s p e c t s f o r A l z h e i m e r s g o l d

- ,l z h e i m e r ' s p a t i e n t s a r e i n d i r e n e e d o f a d i s e a s e s t o p p i n g d r u g a n d t h e c o m p a n y.h a t c o m e s u p w i t h o n e c o u l d h a r v e s t t e n s o f b i l l i o n s o f d o l l a r s i n a n n u a l s a l e s


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Cost-effective treatment

Dementia is associated with high healthcare and socialcosts.

Psychological & Behavioural approach has beenrecommended as best first choice treatment by NICE forpeople with dementia. Stimulation of the brain, such askeeping it active through doing crosswords or puzzles, isthought to help in slowing down the development of dementia.

NICE guidelines recommends treatment of people withmoderate dementia, but not mild dementia, with AChIsas cost-effective within the NHS.

Early detection and intervention services can lead to areduced need for services at a later stage and thereforecost savings.

r u g m a k e r s p r o s p e c t s f o r D e m e n t i a s g o l d


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References Ferri, C., et al. (2005). Study of dementia prevalence.

The Lancet . Vol 366.2112-2117 Medline Plus, 2010 [available online]

http://www.nlm.nih.gov/medlineplus/ency/imagepages/171 Medicine.net 2009 [available online]

http://www.medicinenet.com/dementia_pictures_slideshow

NHS choices, 2009 [available online]http://www.nhs.uk/Conditions/Dementia/Pages/Diagnosis.a About.com, 2009 [available online]

http://alzheimers.about.com/od/diagnosisofalzheimers/tp/T Wrong diagnosis, 2010 [ available online]

http://www.wrongdiagnosis.com/a/alzheimers_ disease/book-diseases-4c.htm
http://www.nlm.nih.gov/medlineplus/ency/imagepages/17146.htmhttp://www.medicinenet.com/dementia_pictures_slideshow/article.htmhttp://www.nhs.uk/Conditions/Dementia/Pages/Diagnosis.aspxhttp://alzheimers.about.com/od/diagnosisofalzheimers/tp/Types-of-Dementia.htmhttp://www.wrongdiagnosis.com/a/alzheimers_disease/book-diseases-4c.htmhttp://www.wrongdiagnosis.com/a/alzheimers_disease/book-diseases-4c.htmhttp://www.wrongdiagnosis.com/a/alzheimers_disease/book-diseases-4c.htmhttp://www.wrongdiagnosis.com/a/alzheimers_disease/book-diseases-4c.htmhttp://alzheimers.about.com/od/diagnosisofalzheimers/tp/Types-of-Dementia.htmhttp://www.nhs.uk/Conditions/Dementia/Pages/Diagnosis.aspxhttp://www.medicinenet.com/dementia_pictures_slideshow/article.htmhttp://www.nlm.nih.gov/medlineplus/ency/imagepages/17146.htm


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Dementia Presentation Final

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