Some have argued that since the positive results of treating Alzheimer’s disease are at best relatively short in duration, the cost of doing so may not be worth the results (“New drug options for neurologic disorders,” May 2010). Any delay in nursing-home placement is well worth the investment in medication. Family members and caregivers of those who do respond have much to gain from even small improvements in activities of daily living (ADLs). Patients and caregivers should be made to understand the limitations of these medications from the outset. It is wonderful that we now have a rather large armamentarium.—Doug Varian, Albuquerque, N.M.
I agree that small changes in social skills and ADLs can make significant improvements in quality of life for both patients and caregivers. These changes may also save money in delayed placement. Perhaps the focus and/or endpoints of research should not be cost of drug per percent change in cognition but cost of drug compared with the cost of early vs. late placement. In addition to the quality-of-life issues, such endpoints would likely provide a truer financial comparison.—Deborah Downey, CNRN, CNS, ANP (141-13)