title: Retrospective study on the benefits of combined Memantine and cholinEsterase inhibitor treatMent in AGEd Patients affected with Alzheimer's Disease: the MEMAGE study.
abstract: BACKGROUND
  Combined therapy of memantine and acetylcholinesterase inhibitors (AChEIs) in patients with Alzheimer's disease (AD) may be associated with higher benefits than either monotherapy.
  
  
  OBJECTIVE
  This retrospective multicentric study conducted in seven Italian Ambulatory Centers for Dementia assessed the efficacy and safety of memantine 20 mg/day administered for 6 months in addition to an AChEI in AD patients with worsened cognitive functions and behavioral disorders.
  
  
  METHODS
  A total number of 240 patients (61.7% of women, 38.3% men, mean age 77.9 ± 7.32 years old) who had started treatment with the combination therapy were recruited. At baseline (T0), Month 3 (T1), and Month 6 (T2), cognitive functions were assessed by Mini-Mental State Examination (MMSE), functional dependence by activities of daily living (ADL) and instrumental ADL, behavioral disturbances by the Neuropsychiatric Inventory (NPI), and comorbidities by Cumulative Illness Rating Scale. Adverse events were reported during the study.
  
  
  RESULTS
  MMSE total score significantly increased at Month 6 (p = 0.029 versus month 3) and IADL total score significantly decreased from baseline to endpoint (p = 0.033). There were no significant changes from baseline in mean ADL, despite significant improvements in NPI total score. The mean MMSE total score significantly increased with the combination donepezil + memantine compared to rivastigmine + memantine. The adverse events profile was in line with the expected range of the drugs studied and concomitant therapies. Overall, 17 patients discontinued treatment in the observation time.
  
  
  CONCLUSIONS
  Combined treatment with memantine and AChEIs was effective in patients with AD, particularly in slowing cognitive impairment and preventing the onset of agitation and aggression in elderly AD patients.
authors.affiliation: Elderly Health Care, Ambulatory Center for Dementia, ASP Catanzaro, Catanzaro, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.affiliation: A.G.E, Naples, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Putignano
authors.affiliation: Ambulatory Center for Dementia, AUSL Modena, Modena, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Castagna
authors.affiliation: ASL2 Turin, Turin, Italy.
authors.forename: Antonino Maria
authors.initials: AM
authors.lastname: Cotroneo
authors.affiliation: DS 3 ASL Bitonto, Bari, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: De Palo
authors.affiliation: Director Dementia Care Program Mirandola District, AUSL Modena, Modena, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabbo
authors.affiliation: Elderly Assistance Unit, ASL NA 2, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Forgione
authors.affiliation: Elderly Assistance Unit, DS 25 ASL NA1, Naples, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Giacummo
authors.affiliation: Elderly Health Care, Ambulatory Center for Dementia, ASP Catanzaro, Catanzaro, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lacava
authors.affiliation: Elderly Assistance Unit, DS 53 Castellammare di Stabia, Naples, Italy.
authors.forename: Saverio
authors.initials: S
authors.lastname: Marino
authors.affiliation: Elderly Assistance Unit, DS 53 Castellammare di Stabia, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Simone
authors.affiliation: Director O.U. of Geriatrics, University Hospital of Ferrara, Ferrara, Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Zurlo
authors.affiliation: Elderly Assistance Unit, Center for Dementia, DS 30 ASL NA1, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Putignano
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D003071:Cognition / Q000187:drug effects; D015897:Comorbidity; D000077265:Donepezil; D005260:Female; D005702:Galantamine / Q000008:administration & dosage; D006801:Humans; D007189:Indans / Q000008:administration & dosage; D007558:Italy; D008297:Male; D008559:Memantine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D048448:Phenylcarbamates / Q000008:administration & dosage; D010880:Piperidines / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D000068836:Rivastigmine; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine; D008559:Memantine
keywords: Alzheimer's disease; acetylcholinesterase inhibitor drugs; elderly; memantine