Drug study aimed at Hispanics

Thursday, Sept. 7, 2006 | 7:13 a.m.

A clinical trial under way in Las Vegas brings to light not only the increased rate of Alzheimer's disease among Hispanics but also the challenges in getting Hispanics to participate in such trials.

The study, at the University of Nevada School of Medicine, will try to determine whether Donepezil, a common medication for Alzheimer's, reacts the same in Hispanics as in other groups.

Effective treatment information is crucial because Hispanics already have a high incidence of the disease (more than 200,000 cases nationwide from a population of 42 million) and are the fastest-growing ethnic group in the country. A recent report by the Alzheimer's Association indicates that based on current trends, more than 1.3 million Hispanics will fall victim to the disease by 2050.

Unfortunately, as Dr. Charles Bernick of the Nevada School of Medicine points out, that estimate may be low.

"Hispanics are also expected to have the longest life expectancy of any ethnic group as well, and age is the single greatest risk factor for Alzheimer's disease," he said.

Experts attribute Hispanic longevity to genetics, cultural aspects such as solid family ties, and lifestyle and behavior choices.

It is believed that by the middle of the century, the life expectancy of U.S. Hispanics will increase to 87 years, which means they will jump from 5 percent of the overall elderly population to 16 percent, according to the Alzheimer's Association. In addition, Hispanics develop symptoms of Alzheimer's about five years sooner than other groups, which further expands the pool of people potentially affected.

With these alarming statistics and so many victims of the disease, it would seem research participants would be easy to find.

That's not the case.

Bernick said he could accommodate an unlimited number of subjects for the Donepezil trial but has had a hard time finding even the four participants required for the study.

"Obviously, the more participants we have, the more representative our results will be," he said. "We think the medicine works the same in Hispanics as it does in everyone else, but it's important to find that out."

Alzheimer's disease is a progressive brain disorder that gradually destroys a person's memory and ability to learn, reason, make judgments, communicate and carry out daily activities.

Donepezil, commonly known as Aricept, has been approved by the Food and Drug Administration since 1996, and almost 4 million people have used it. It has been proved to help overall function in patients, including the effects on memory and behavior.

Bernick said there are several reasons Hispanics are less likely than others to participate in clinical trials, including a general apprehension about experimental medical treatments and a lower-than-average rate of health insurance.

Often, clinical trial information is distributed by family physicians or specialists, and people without access to these services do not know what options are available.

Deborah Schaus, executive director of the Alzheimer's Association Desert Southwest Chapter, said the group is working to expand grass-roots education about treatment options.

"A more structured outreach program is needed to develop a relationship in the communities with groups such as churches and community centers," Schaus said.

The Desert Southwest Chapter, which has its headquarters in Phoenix and a regional office in Las Vegas, includes Arizona and Southern Nevada.

Schaus said an aggressive outreach program is crucial in Clark County, which has an ever-increasing number of senior citizens and a population that is 25 percent Hispanic.

The group already has community-based programs in Phoenix and Tucson that include the widespread distribution of bilingual brochures. It is expanding that effort in Las Vegas.

The increase in Alzheimer's disease may be an indication of a larger problem in some Hispanic communities.

Many other symptoms considered risk factors for Alzheimer's, including Type 2 diabetes and lower education levels, are also higher than average among Hispanics.

Bernick realizes it may be hard for some to understand the relationship between a lack of education and the development of a debilitating illness such as Alzheimer's.

He compares the brain to a highway system with a network of roads built through education. When the roads are attacked by diseases such as Alzheimer's, the brain can use "detours" to fight the effects of the disease. More roads of knowledge provide more detours.

Bernick said that it is essential for the Hispanic community to recognize and focus on improving risk factors such as education. He also pointed out that treatment of illnesses such as diabetes are equally important.

"An increased access and willingness to participate in treatments for these illnesses that are risk factors could prove to be almost as valuable as Alzheimer's trials," he said.

"By reducing the number of people who have these illnesses, we could, by extension, have an impact on Alzheimer's."