title: Effectiveness of the combination of memantine plus vitamin D on cognition in patients with Alzheimer disease: a pre-post pilot study.
abstract: OBJECTIVE
  To determine whether treatment with memantine plus vitamin D is more effective than memantine or vitamin D alone in improving cognition among patients with Alzheimer disease (AD).
  
  
  METHODS
  We studied 43 white outpatients (mean 84.7 ± 6.3 years; 65.1% women) with a new diagnosis of AD, who had not taken anti-dementia drugs or vitamin D supplements. We prescribed memantine alone (n = 18), vitamin D alone (n = 17), or memantine plus vitamin D (n = 8) for an average of 6 months. We assessed cognitive change with the Mini-Mental State Examination (MMSE). We used age, sex, pre-treatment MMSE score, and duration of treatment as covariables.
  
  
  RESULTS
  Before treatment, the 3 groups had comparable MMSE scores. At 6 months, participants taking memantine plus vitamin D increased their MMSE score by 4.0 ± 3.7 points (P = 0.034), while participants taking memantine alone remained stable (change of 0.0 ± 1.8 points; P = 0.891), as did those taking vitamin D alone (-0.6 ± 3.1 points; P = 0.504). Treatment with memantine plus vitamin D was associated with improvement in the MMSE score compared to memantine or vitamin D alone after adjustment for covariables (P < 0.01). Mixed regression analysis showed that the visit by combined treatments (memantine plus vitamin D) interaction was significant (P = 0.001), while memantine or vitamin D alone showed no effect.
  
  
  CONCLUSIONS
  Patients with AD who took memantine plus vitamin D for 6 months had a statistically and clinically relevant gain in cognition, underlining possible synergistic and potentiating benefits of the combination.
authors.affiliation: Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, Angers, France. ceannweiler@chu-angers.fr
authors.forename: Cédric
authors.initials: C
authors.lastname: Annweiler
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.forename: Bruno
authors.initials: B
authors.lastname: Fantino
authors.forename: Bernard
authors.initials: B
authors.lastname: Brugg
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000494:pharmacology / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D010865:Pilot Projects; D016896:Treatment Outcome; D014807:Vitamin D / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D018697:Nootropic Agents; D014807:Vitamin D; D008559:Memantine