Specific functional effects of memantine treatment in patients with moderate to severe Alzheimer’s...
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Doody R., Wirth Y., Schmitt F. and Möbius H.J. Dement Geriatr Cogn Disord 2004; 18:227 – 232 PowerPoint PPT Presentation


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Specific functional effects of memantine treatment in patients with moderate to severe Alzheimer’s disease. Doody R., Wirth Y., Schmitt F. and Möbius H.J. Dement Geriatr Cogn Disord 2004; 18:227 – 232. Baseline Characteristics. US StudyEU Study. MemantinePlaceboMemantinePlacebo

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Doody R., Wirth Y., Schmitt F. and Möbius H.J. Dement Geriatr Cogn Disord 2004; 18:227 – 232

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Doody r wirth y schmitt f and m bius h j dement geriatr cogn disord 2004 18 227 232

Specific functional effects of memantine treatment in patients with moderate to severe Alzheimer’s disease

Doody R., Wirth Y., Schmitt F. and Möbius H.J.

Dement Geriatr Cogn Disord 2004; 18:227–232


Baseline characteristics

Baseline Characteristics

US StudyEU Study

MemantinePlaceboMemantinePlacebo

(N = 126)(N = 126)(N = 41)(N = 38)

Patients completing study, N (%)97 (77%)84 (67%)39 (95%)37 (97%)

Gender, femaleN (%)91 (72%)79 (63%)29 (71%)24 (63%)

Mean age (years)75.976.373.474.9

Race, CaucasianN (%)112 (89%)115 (91%)41 (100%)38 (100%)

Mean MMSEscore at baseline7.78.16.76.8

Residential status outpatients nursing home patients

Doody et al., Dement Geriatr Cogn Disord 2004


Beneficial effects of memantine on function in ad outpatients i

Beneficial Effects of Memantine on Function in AD Outpatients (I)

Mean change (±SEM) from baseline in ADCS-ADL19 item scores (US trial)

Pay attention to conversation*

Use a telephone#

Watch television

Get around outside of his/her home#

Dispose of garbage or litter*

Clear dishes from table after meal*

Find his/her personal belongings

Memantine

Placebo

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

Decline

Improvement

* p < 0.05, # p < 0.10

Doody et al., Dement Geriatr Cogn Disord 2004


Beneficial effects of memantine on function in ad outpatients ii

Beneficial Effects of Memantine on Function in AD Outpatients (II)

Mean change (±SEM) from baseline in ADCS-ADL19 item scores

Turn light off without help

Turn light on without help

Turn off faucet without help

Run water from a faucet to wash

Obtain a hot or cold beverage

Left on his/her own

Memantine

Placebo

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

Decline

Improvement

Doody et al., Dement Geriatr Cogn Disord 2004


Beneficial effects of memantine on function in ad outpatients iii

Beneficial Effects of Memantine on Function in AD Outpatients (III)

Mean change (±SEM) from baseline in ADCS-ADL19 item scores (US trial)

Physically getting dressed

Grooming

Bathing

Toiletting

Walking

Eating

Memantine

Placebo

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

Decline

Improvement

Doody et al., Dement Geriatr Cogn Disord 2004


Consistent beneficial effects on function in ad outpatients

Consistent Beneficial Effects on Function in AD Outpatients

Mean change (±SEM) from baseline in ADCS-ADL19 item scores

Pay attention to conversation*

Turn light off

Dispose of garbage*

Turn faucet off

Get around outside#

Use a telephone#

Run water from a faucet

Walking

Watch television

Clear dishes from table*

Find personal belongings

Turn light on

Toiletting

Eating

Grooming

Left on his/her own

Bathing

Obtain a beverage

Getting dressed

Memantine

Placebo

-0.8

-0.6

-0.4

-0.2

0

0.2

0.4

Decline

Improvement

* p < 0.05, # p < 0.10

Doody et al., Dement Geriatr Cogn Disord 2004


Beneficial effects of memantine on function in nursing home patients i

Beneficial Effects of Memantine on Function in Nursing Home Patients (I)

Mean change (±SEM) from baseline in G2-scale scores (EU study)

Mobility in bed

Ability to stand up*

Ability to move*

Ability to wash

Ability to bath/take a shower

Ability to dress*

Ability to eat*

Ability to drink*

Use of toilet*

Memantine

Placebo

0.2

0

-0.2

-0.4

-0.6

-0.8

Improvement

* p < 0.05

Doody et al., Dement Geriatr Cogn Disord 2004


Beneficial effects of memantine on function in nursing home patients ii

Beneficial Effects of Memantine on Function in Nursing Home Patients (II)

Mean change (±SEM) from baseline in G2-scale scores (EU study)

Understanding

Communicates

Orientation

Recognition of persons

Group activities#

Hobbies#

Sleeping-waking rhythm

Behaviour

Memantine

Placebo

0.2

0

-0.2

-0.4

-0.6

-0.8

Improvement

# p < 0.10

Doody et al., Dement Geriatr Cogn Disord 2004


Summary

Summary

  • The ADL single item analyses consistently confirm that memantine monotherapy provides significant benefits on functional abilities for patients with moderate to severe Alzheimer’s disease

  • The benefits have been demonstrated in both outpatients (Reisberg et al., 2003) and nursing home patients (Winblad and Poritis, 1999)

  • The positive effects of memantine on function may not only have a positive impact on the patient but also on the caregiver and healthcare resource utilization


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