The Central Georgian

New Drug said to be Effective in Helping Blacks with Alzheimer's Disease

By Lorinda M. Bullock, NNPA National Correspondent

WASHINGTON (NNPA) - When Jonathan Lackland's grandmother, Cora, forgot to turn off the lights or stove, the family just thought she was tired and missing her deceased husband Richard. But when those types of things happened more often and the woman known for being "meticulous" was now listless and easily agitated, the Lacklands knew it was more than grief.

"In the beginning you blow it off, oh she just made a mistake," said Jonathan Lackland.

"But we began to see changes in terms of how lethargic she had become... She'd get very frustrated if she couldn't make a point-meaning she would forget-and normally this was unlike her and that's when we began to realize something just isn't right," he said.

And it was more than fatigue and loneliness that was changing Cora Lackland. It was Alzheimer's disease.

The 87-year-old from Illinois represents a growing number of elderly African-Americans, who are statistically at the greatest risk to get the memory-erasing disease.

But a study released this month in the Journal of the National Medical Association may bring hope to hundreds of thousands of African-American families like the Lacklands.

The study, led by Dr. Patrick Griffith of Meharry Medical College in Nashville, revealed that a drug called donepezil-more commonly known as the brand name Aricept-is safe and effective for 80 percent of the African-American seniors with mild to moderate Alzheimer's disease.

For the patients who took the drug during a 12-week period, memory, behavior and their ability to perform daily activities improved "significantly," the study found.

According to Griffith, the study is the first of its kind to target a particular drug and its effect on African-American Alzheimer's patients.

"This (African-Americans) is a group that typically doesn't like to participate in clinical trials and so it's quite a tour de force for us to get 126 patients enrolled with a completion rate of almost 80 percent. We're very happy," he said.

Griffith's findings have come at a crucial time.

Not only are African-Americans are a high-risk group for Alzheimer's disease, but the number of African-Americans over the age of 65 with the disease is expected to double by 2030 to 6.9 million.

Alzheimer's can be hereditary, but it is only for 15 percent of African-Americans, Griffith said.

"This risk is highest for African-American first degree relatives and for the oldest daughter of African-Americans with Alzheimer's disease. We haven't found in our database, a genetic marker the way they have in the major community," he said.

According to the Alzheimer's Association, there are 4.5 million Americans living with the disease. As it progresses, individuals may experience a change in their personality, become easily agitated and even have hallucinations. In the late stages of the disease, the person needs help with basic daily activities such as eating, dressing and bathing.

Lackland said after trying to care for his grandmother at home with an aunt in Chicago, it eventually became too difficult as Cora became more combative. The family then made the tough decision to admit her to a northern Illinois nursing home.

Although, she's safe in the nursing home, Lackland said family members are still nervous about the potential for her to wander or agitate her heart problems. They often take turns visiting to keep an eye on her as well assess the care she's getting.

Griffith said the Lackland's initial reaction is a normal one because families often shrug off the early symptoms and believe it is a natural part of aging. But as with most diseases, early detection and screening is essential.

"The problem is the people older than age 65 are at risk and the risk goes up to almost 50 percent in people older than age 85," Griffith said. "So what you want is a community that's educated to look for early signs. So that when a loved one is forgetful or missing office appointments or not keeping office appointments or can't take messages, that's the time to get them screened and tested to see if it could be early Alzheimer's rather than brushing it off and saying 'Oh, they're just getting old.'"

Cora Lackland's diagnosis didn't come until three years ago, but Jonathan Lackland said he did see some signs of her deterioration, including a car accident that was the result of her mistakenly running a red light.

With a history of congestive heart failure, Cora Lackland seems to fits the common profile for African-American Alzheimer's patients. Griffith said hypertension, high cholesterol and diabetes are often responsible for the onset Alzheimer's in African Americans and a particular kind of disease called vascular dementia.

Vascular dementia is caused by strokes or other conditions that affect the blood supply to the brain.

Griffith and other researchers have found that with early detection, proper diet and donepezil, Alzheimer's patients can lead a more balanced life.

Up to 72 percent of patients taking donepezil improved in areas of memory and cognition, the study said.

As with a number of health-related issues, low income African-Americans have difficulty with access to support programs, and may be uninsured or underinsured. Experts say, in many cases, America's emergency rooms become primary care facilities and at that point an illness is quite advanced.

"Some African-American caregivers have to choose between going to work to obtain a reasonable living and stopping and getting off work to take loved ones to the doctor. In some of these groups where income is a problem, they're forced to choose and unfortunately there's a delay in seeking an evaluation and also a delay sometimes on the part of the providers that consider this," Griffith said.

That is why people like Shelia Jack, associate director of diversity outreach at the Alzheimer's Association, oversees the programs created to provide educational tools and assistance to African Americans in the 79 chapters of the national organization.

Jack agreed that health care access is a major problem for Black America's seniors and said in 2005, the ratio of uninsured African-Americans 65 and older to insured White Americans of the same age was 30 to 1.

"A lot of (elderly) African-Americans didn't have good health plans when they were working and now that they're older don't have any coverage or their coverage lapsed," she said.

Jack said local chapters are reaching out to churches to spread the word about the support programs the organization provides. But she said more work must be done and more African-Americans must take part in studies like Griffith's.

"The response in the African-American community is building. It has a lot of possibilities, (but) it's not where we want it to be," she said.

Lackland started working for the Alzheimer's Association's Illinois chapter as a public policy director. His personal experiences with his grandmother made him leave a lengthy career as a lobbyist to join the Alzheimer's Association staff.

Describing participation in organizations like the Alzheimer's Association as "critical," he said the support groups and educational programs not only empower families but uplift them.

"I say if I cannot cope with this, if I cannot find ways to handle my emotions with this illness, I can never be there for my grandmother."

Everyday, the Lacklands brace themselves for the good days when Cora remembers her grandchildren and children. They also brace themselves for the bad days too, when she's angry and afraid of a visiting relative she hasn't seen in a year.

Despite the Russian roulette of emotions they face daily, Lackland says the family counts everyday they can spend with her, no matter what frame of mind she's in, as a good one.

He's excited that new medicine may help other families like his have better "good" days.

"Knowing there's some clinical trials taking place, knowing that there's a possibility of having a drug that may help in some way, shape, form or fashion is very key," he said.

"At least when I look at the fact that they are trying to do something to figure out and to understand this disease-because this disease is very clever and it can switch and change on you-and being in that position to know again that there's some drugs, there's some research taking place, that's always a plus."

The Central Georgian, 2006,  Disclaimer..