Effects of memantine on cognition in patients with moderate to severe Alzheimer's disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, double-blind, placebo-controlled studies.
OBJECTIVE
The post-hoc analyses reported here evaluate the specific effects of memantine treatment on ADAS-cog single-items or SIB subscales for patients with moderate to severe AD.


METHODS
Data from six multicentre, randomised, placebo-controlled, parallel-group, double-blind, 6-month studies were used as the basis for these post-hoc analyses. All patients with a Mini-Mental State Examination (MMSE) score of less than 20 were included. Analyses of patients with moderate AD (MMSE: 10-19), evaluated with the Alzheimer's disease Assessment Scale (ADAS-cog) and analyses of patients with moderate to severe AD (MMSE: 3-14), evaluated using the Severe Impairment Battery (SIB), were performed separately.


RESULTS
The mean change from baseline showed a significant benefit of memantine treatment on both the ADAS-cog (p < 0.01) and the SIB (p < 0.001) total score at study end. The ADAS-cog single-item analyses showed significant benefits of memantine treatment, compared to placebo, for mean change from baseline for commands (p < 0.001), ideational praxis (p < 0.05), orientation (p < 0.01), comprehension (p < 0.05), and remembering test instructions (p < 0.05) for observed cases (OC). The SIB subscale analyses showed significant benefits of memantine, compared to placebo, for mean change from baseline for language (p < 0.05), memory (p < 0.05), orientation (p < 0.01), praxis (p < 0.001), and visuospatial ability (p < 0.01) for OC.


CONCLUSIONS
Memantine shows significant benefits on overall cognitive abilities as well as on specific key cognitive domains for patients with moderate to severe AD.
Mecocci
Patrizia
P
Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy. mecocci@unipg.it
Bladström
Anna
A
Stender
Karina
K
D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology; D003071:Cognition / Q000187:drug effects*; D003627:Data Interpretation, Statistical; D018450:Disease Progression; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000188:drug therapy* / Q000523:psychology; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D008568:Memory / Q000187:drug effects*; D015337:Multicenter Studies as Topic; D009483:Neuropsychological Tests; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome
D018691:Excitatory Amino Acid Antagonists; D010919:Placebos; D008559:Memantine