Majority of Physicians,(1) Alzheimer’s Disease (AD) Carers(1) and the General Public(1) in Five European Countries Understand the Need to Detect and Treat AD Early, Yet the Disease Remains Significantly Under-Diagnosed(2)

VIENNA -

- Attitudinal and Behavioural Barriers(1) - Combined with Inability to Recognize Disease Symptoms(1) - Contribute to Delay in Diagnosis and Treatment

A new study presented today at a major International medical meeting reveals that approximately two-thirds of physicians in the United Kingdom, France, Italy, Spain and Germany agree that Alzheimer’s disease (AD) is under-diagnosed(1) and under-treated,(1) and explains how physicians, carers and the general population share responsibility in the issue. Based on these results, the Steering Committee overseeing the study recommends the development of programmes to help physicians meet the specific challenges associated with diagnosing such a devastating disease, and educational tools for physicians and the general population to help them spot the early signs of AD.

According to the study, which was presented at the 2009 Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD 2009) and sponsored by Eisai and Pfizer Inc, physicians who feel AD is under-diagnosed believe this can be explained by:

- Physician uncertainty in discussing the early stages of AD (76 percent)(1) - Family tendency to ignore (79 percent)(1) or not watch for (90 percent)(1) the early symptoms - An apathetic ‘what’s the point?’ attitude, as 57 percent of physicians(1) agreed that there is little to gain from diagnosis, as there are no effective treatments - Emotional barriers making it uncomfortable for physicians to deliver bad news (54 percent)(1)

These beliefs exist despite the fact that 74 percent of physicians(1) and 63 percent of carers(1) agree that early treatment delays the progression of disease symptoms in some patients. The Steering Committee concluded that such attitudes and behaviours prevalent across Europe may have a negative impact on AD patients’ and carers’ quality of life and ability to benefit from timely diagnosis. Prompt diagnosis has several advantages, including the opportunity to start treatment, which can delay decline in ability to perform day-to-day activities,(3) decrease carer burden(4) and stress,(5) and delay patient admission to long-term care institutions.(6) Addressing the disease without delay also provides more time for a person with AD and their family to adjust to the news, join support organisations and plan for the future, financially and emotionally.(7)

“Undoubtedly external political and social factors which vary from country to country, including government resources, cost and treatment restrictions, take their toll on diagnosis and treatment rates. However, this study brings to light attitudinal and behavioural factors within our control that may be just as important barriers to effective management of this devastating disease, the most common form of dementia, which is due to rise by approximately 70 percent by the year 2040, affecting 10 million people in Europe,” said Professor Roy Jones, Clinical Gerontologist and Geriatrician at The Research Institute for the Care of Older People, Bath, and Study Steering Committee Chair.

Need for Increased Awareness of Early AD Symptoms - Among Physicians and the General Public

Additional results of the “Important Perspectives on Alzheimer’s Care & Treatment,” or IMPACT study, highlight an agreement that many people would not be able to recognize the early signs of AD,(1) or be able to tell the difference between AD and normal ageing.(1) This is reinforced by the finding that carers waited an average of 10 months to call a physician after noticing the signs of disease.(1) Across all respondents, a majority also feel that general practitioners (vs. specialists) have a difficult time detecting the early stages of AD.(1) This delay in seeking a physician’s advice, and lack of awareness of the early signs, may place future patients and their families at a potential disadvantage in securing the benefits of timely diagnosis and treatment.(7) As the incidence of AD continues to rise across Europe,(8) “anyone” could be in the position to identify signs of AD in someone they love in the future.

“Whilst carers and physicians alike know that early treatment delays the progression of disease symptoms, almost a year goes by before carers call physicians, who themselves may then be too inexperienced, uncertain or otherwise emotionally unable to deliver timely diagnosis and treatment. Detecting the early signs of the disease is challenging for everyone, but we need to move people away from fear, denial and hesitation, so that physicians and the general population - our future carers - can increase their knowledge of AD, and put that knowledge into action,” said Professor Pablo Martinez-Lage, Neurologist at the Institut Catala de Neurociencies Aplicades, Barcelona, and member of the IMPACT Study Steering Committee.

Desire to Know Outweighs Fear of Disease and its Impact on Families

IMPACT also suggests that the physicians’ perception of the impact of AD on the family may be greater than that of the carers. Approximately nine out of ten physicians agree that AD has a devastating effect on a family,(1) but significantly fewer carers (75 percent)(1) feel that way. Further, although the study shows AD carers are the only respondents to fear AD more than cancer,(1) they would still want to know as soon as possible if they(1) or a family member had the disease.(1)

Marc Wortmann, Executive Director of Alzheimer’s Disease International and member of the IMPACT Study Steering Committee, said, “We have found through IMPACT that fear does not overwhelm the carer desire to find out about Alzheimer’s disease as early as possible. Perhaps physicians underestimate this desire to know because of their unique knowledge of the path ahead and ‘over concern’ about the impact of a diagnosis. We need to act now to address the unique obstacles facing physicians, carers and the general population, and tackle the barriers influencing how people feel and act when it comes to Alzheimer’s disease. How we choose to react to today’s challenges will determine our ability to best support the rising numbers of tomorrow’s patients and carers. Many health systems in the world are not ready for this challenge.”

Notes to Editors:

About Alzheimer’s Disease

Alzheimer’s disease, a progressive and degenerative brain disease,(9) is the most common type of dementia.(9) Dementia affects more than 30 million people worldwide(10) including more than six million Europeans.(8) Symptoms of AD may include increased forgetfulness, repeating or asking the same question frequently, and problems making decisions.(11) These symptoms gradually affect a person’s cognition, behavior and everyday activities, some severe enough to have an impact on their work, social activities and family life.(11) While there is no cure for AD, there are treatments to help slow the progression of the symptoms of the disease.(12)

About the IMPACT Study

The IMPACT study was conducted online within the United Kingdom, France, Italy, Spain and Germany by IPSOS on behalf of Eisai and Pfizer Inc, between April 1 and May 1, 2009, among 500 physicians (including general practitioners and specialists), 250 AD carers, 50 payors and 1,000 members of the general population age 18 and over. Statistical differences are noted using a 90 percent confidence interval. A full methodology is available upon request.

About the IMPACT Study Steering Committee

The IMPACT study was developed and implemented with the oversight of an expert Steering Committee comprised of a variety of leading AD specialists, including geriatricians, neurologists, epidemiologists, primary care physicians, old-age psychiatrists and advocacy leaders from the United Kingdom, France, Italy, Spain and Germany. The Committee was sponsored by Eisai and Pfizer Inc.

About Eisai

Eisai is a research-based human health care (hhc) company that discovers, develops and markets products throughout the world. Eisai focuses its efforts in three therapeutic areas: Integrative Neuroscience including neuroscience, neurology and psychiatric medicine; Integrative Oncology including oncotherapy and supportive-care treatment and Vascular/Immunological Reaction which includes acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis and Crohn’s disease. Through a global network of research facilities, manufacturing sites and marketing subsidiaries, Eisai actively participates in all aspects of the worldwide health care system. Globally, Eisai operates in five key regions: its home market of Japan, North America, China, Asia/Oceania/Middle East and Europe and employs more than 11,000 people worldwide.

Pfizer Inc: Working together for a healthier world(TM)

Founded in 1849, Pfizer is the world’s premier biopharmaceutical company taking new approaches to better health. We discover, develop, manufacture and deliver quality, safe and effective prescription medicines to treat and help prevent disease for both people and animals. We also partner with healthcare providers, governments and local communities around the world to expand access to our medicines and to provide better quality health care and health system support. At Pfizer, more than 80,000 colleagues in more than 90 countries work every day to help people stay happier and healthier longer and to reduce the human and economic burden of disease worldwide.

(1) Impact Study 2009: Global Alzheimer’s Awareness Study. Data on File Eisai, Pfizer Ltd (2) Alzheimer Europe. Dementia in Europe Yearbook 2008. Alzheimer Europe. 2008. (3) Mohs, R.C. et al. A 1-year, placebo-controlled preservation of function survival study of donepezil in AD patients. Neurology. 2001; 57:481-488. (4) Wimo, A. et al. An Economic Evaluation of Donepezil in Mild to Moderate Alzheimer’s Disease: Results of a 1-year, Double-Blind, Randomized Trial. Dementia and Geriatric Cognitive Disorders. 2003; 15:44-54. (5) Feldman, H. et al. Efficacy of Donepezil on Maintenance of Activities of Daily Living in Patients with Moderate to Severe Alzheimer’s Disease and the Effect on Caregiver Burden. Journal American Geriatrics Society. 2003; 51:737-744. (6) Geldmacher, D. et al. Donepezil Is Associated with Delayed Nursing Home Placement in Patients with Alzheimer’s Disease. Journal American Geriatrics Society. 2003; 51:937-944. (7) Alzheimer’s Association. Diagnosis. Available at alz.org/alzheimers_disease_diagnosis.asp and alz.org/alzheimers_disease_life_after_diagnosis.asp (8) Alzheimer Europe. Policy watch Europe Unites Against Alzheimer’s disease. Dementia In Europe: The Alzheimer Europe Magazine. December 2008;2: 2-11. (9) Alzheimer’s Association. 2009 Alzheimer’s Disease Facts and Figures. Available at: www.nadsa.org/publications/documents/2008_Alzheimers_Facts_web.pdf. Accessed, June 9, 2009. (10) Wortmann, M. et al. New Estimates of Numbers of People With Dementia Worldwide. Alzheimer’s Disease International Global Perspective. 2008;18: 10-12. (11) Alzheimer’s Association. 10 Signs of Alzheimer’s www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp (12) Alzheimer’s Association. Treatments Available at alz.org/alzheimers_disease_treatments.asp and www.alz.org/alzheimers_disease_standard_prescriptions.asp

Source: Eisai; Pfizer Inc

Andrew Day, Eisai, +44-7973-411-419, Andrew_day at eisai.net; or Louise Clark, Pfizer, +44-845-300-8033, pressofficeUK at pfizer.com; or Vanessa Leon, Chamberlain, +44-20-7611-8091, Vleon at chamberlainpr.com