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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 Study EU Study . Memantine Placebo Memantine Placebo
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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 Study EU Study Memantine Placebo Memantine Placebo (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) 75.9 76.3 73.4 74.9 Race, CaucasianN (%) 112 (89%) 115 (91%) 41 (100%) 38 (100%) Mean MMSEscore at baseline 7.7 8.1 6.7 6.8 Residential status outpatients nursing home patients Doody et al., Dement Geriatr Cogn Disord 2004
Beneficial Effects of Memantine on Function in AD Outpatients (I) 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) 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) 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 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) 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) 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 • 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