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New International Survey Reveals Multiple Barriers to an Accurate and Timely Alzheimer's Disease Diagnosis
Date:9/19/2012

INDIANAPOLIS, Sept. 19, 2012 /PRNewswire/ -- Eli Lilly and Company (NYSE: LLY) today announced results from the International Alzheimer's Disease Physician Survey of nearly 1,000 physicians that assessed physician attitudes and beliefs on the barriers to a formal Alzheimer's disease diagnosis. The survey, in recognition of World Alzheimer's Day (September 21, 2012),1 was conducted by Adelphi Research, on behalf of Lilly, in the United States (US), United Kingdom (UK), France, Italy and Japan.2

Nearly half of all physicians surveyed (45 percent) 2 from the five participating countries responded that Alzheimer's disease is "often" misdiagnosed, with nearly half (48 percent) indicating the diagnosis "always" or "often" occurs too late to intervene in a meaningful way. 2 Lack of definitive tests, lack of communication between patients and/or caregivers and physicians, and patient denial, were cited as the most common barriers perceived by physicians as impacting their ability to make a formal Alzheimer's disease diagnosis, according to the survey results.2  

Additionally, physicians surveyed agreed that there are several advantages of an earlier diagnosis among Alzheimer's disease patients, including initiating treatment as soon as possible in an effort to slow progression of functional and cognitive impairment before they worsened, and allowing more time for patients and caregivers to adjust and prepare for the future. 2 The latter was found to be most important to physicians who took part in the survey in the US (85 percent) and UK (83 percent).2 Physicians surveyed also acknowledged several disadvantages, including the news of an incurable disease to patients and family and the potential for isolation from other relatives and friends.2

Barriers to Formal Diagnosis

Lack of definitive tests

The majority of physicians indicated they were "moderately satisfied" (57 percent) with tools available to make a formal Alzheimer's disease diagnosis.2 A lack of definitive tests was cited as the top barrier (65 percent) among physicians surveyed in all countries.2

Lack of communication

Of the physicians surveyed, 75 percent reported that discussions about Alzheimer's disease were initiated by patients and caregivers.2 Further, 44 percent of physicians surveyed reported that patients and/or caregivers initiated the discussion after they suspected "Alzheimer's disease was present for a while."2 Additionally, 40 percent of respondents reported that patients and caregivers did not provide enough information to help them make a formal diagnosis.2 When asked what information would aid them in making a more definitive diagnosis in the absence of clinical evidence, physicians surveyed indicated that reports about the types and durations of symptoms, how symptoms affect daily life, rate of decline and family history would help.2

"The journey to receiving an Alzheimer's disease diagnosis can be a complex process," said Eric Siemers, M.D., senior medical director of Lilly's Alzheimer's disease team. "Given a wide variety of emotions, it is often understandably difficult to communicate important information to physicians. We hope this survey is helpful to patients and caregivers as it highlights ways to partner more closely with their physicians."

Denial and stigma

Physicians who took part in the survey also reported that communicating an Alzheimer's disease diagnosis to patients can be difficult due to patient denial (65 percent) and social stigma (59 percent).2 The majority of respondents (71 percent) agreed that there was at least a moderate level of stigma associated with Alzheimer's disease, with physicians who took part in the survey in the UK and France reporting the most stigma (81 percent).2 Physicians surveyed also indicated that loss of personal freedom (78 percent), shame (63 percent) and possible isolation (60 percent) are mentioned by patients and/or caregivers as common stigmas.2

"Stigma remains a large area of concern for patients and their loved ones facing an Alzheimer's disease diagnosis, making acceptance of this debilitating disease that much more difficult," said Marc Wortmann, executive director, Alzheimer's Disease International. "We need to continue our efforts to educate the public about this illness to better accept the people living with Alzheimer's disease and other dementias."

To address these important needs, Lilly, Alzheimer's Disease International (ADI) and other key stakeholders plan to work together to develop educational resources to help aid in more effective patient/caregiver and physician conversations. These resources will focus on helping patients and caregivers better identify key cognitive symptoms that could indicate a more serious issue, as well as how best to communicate information and concerns to their physicians.

About Alzheimer's Disease

Alzheimer's disease, the most common form of dementia, causes progressive decline in memory and other aspects of cognition. Researchers do not know exactly what causes Alzheimer's disease and there are currently no approved treatments shown to alter the course of the underlying disease process, only treatment options that reduce certain symptoms of the disease.3 As of 2010, ADI estimated that there are currently 35.6 million people with dementia worldwide, with 7.7 million new cases each year (which implies one new case every four seconds).4 The number of people affected is estimated to be over 115 million by 2050.4 Estimates vary, but experts suggest that as many as 5.4 million Americans may have Alzheimer's disease.3

About The International Alzheimer's Disease Physician Survey2

The International Alzheimer's Disease Physician Survey was conducted between July 11, 2012, and August 20, 2012, among physicians in the US, UK, France, Italy and Japan. A total of 996 physicians, consisting of primary care physicians (PCP), psychiatrists, neurologists, geriatricians and geriatric psychiatrists (UK only), participated. In order to qualify for the survey, physicians had to meet the following criteria: been in practice between two and 30 years; for PCPs and neurologists, greater than 70 percent of their time must have been in direct patient care; for geriatricians, psychiatrists and geriatric psychiatrists (UK), greater than 50 percent of their time must have been in direct patient care; all physicians must have seen at least 10 patients over the last three months, 50 percent of which must have been older than 19 years of age; all physicians had to indicate that they manage Alzheimer's disease on a regular basis; and all physicians must have agreed to Consent Agreement and Adverse Event reporting standards.

About Eli Lilly and Company

Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world's most urgent medical needs. Additional information about Lilly is available at www.lilly.com.

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1 About WAM. Alzheimer's Disease International Web site. http://www.alz.co.uk/world-alzheimers-month/about. Accessed September 13, 2012.

2 Data on file, Eli Lilly and Company: AMY20120913A.

3 Thies W, Bleiler L; Alzheimer's Association. Alzheimer's Association report: 2012 Alzheimer's disease facts and figures. Alzheimers Dement. 2012;8:131-168.

4 Alzheimer's Disease International, World Health Organization. Dementia: a public health priority. http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf. Published 2012. Accessed September 6, 2012.

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