title: Treatment effect of memantine on survival in dementia with Lewy bodies and Parkinson's disease with dementia: a prospective study.
abstract: OBJECTIVE
  To investigate the effect on survival of treatment with memantine in patients with dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD).
  
  
  METHODS
  75 patients with DLB and PDD were included in a prospective double-blinded randomised placebo-controlled trial (RCT) of memantine, of whom long-term follow-up was available for 42. Treatment response was recorded 24 weeks from baseline and measured by Clinical Global Impression of Change (CGIC). The participants were grouped as responders (CGIC 1-3) or non-responders (CGIC 4-7). The 24-week RCT was followed by open-label treatment and survival was recorded at 36 months.
  
  
  RESULTS
  After 36-month follow-up, patients in the memantine group had a longer length of survival compared with patients in the placebo group (log rank x²=4.02, p=0.045). Within the active treatment group, survival analysis 36 months from baseline showed that the memantine responders, based on CGIC, had higher rates of survival compared with the non-responders (log rank x²=6.595, p=0.010). Similar results were not seen in the placebo group.
  
  
  CONCLUSIONS
  Early treatment with memantine and a positive clinical response to memantine predicted longer survival in patients with DLB and PDD. This suggests a possible disease-modifying effect and also has implications for health economic analysis. However, owing to the small study sample, our results should merely be considered as generating a hypothesis which needs to be evaluated in larger studies.
  
  
  BACKGROUND
  ISRCTN89624516.
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden Department of Rheumatology, Skaraborg Central Hospital, Skövde, Sweden.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Stubendorff
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Victoria
authors.initials: V
authors.lastname: Larsson
authors.affiliation: Wolfson Centre for Age Related Diseases, King's College London, London, UK.
authors.forename: Clive
authors.initials: C
authors.lastname: Ballard
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Lennart
authors.initials: L
authors.lastname: Minthon
authors.affiliation: Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway Department of NVS, Neurobiology Ward Sciences and Society, Alzheimer's Disease Research Center, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Dag
authors.initials: D
authors.lastname: Aarsland
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Londos
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D003704:Dementia / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D000978:Antiparkinson Agents; D008559:Memantine