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

1
Specific functional effects of memantine
treatment in patients with moderate to severe
Alzheimers disease

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

2
Baseline Characteristics
Doody et al., Dement Geriatr Cogn Disord 2004
3
Beneficial Effects of Memantine on Function in AD
Outpatients (I)
Mean change (SEM) from baseline in ADCS-ADL19
item scores (US trial)

Get around outside of his/her home Dispose of
garbage or litter Find his/her personal
belongings Clear dishes from table after meal Pay
attention to conversation Watch television Use a
telephone



? Memantine ? Placebo

-0.6
-0.4
-0.2
0
0.2
-0.8
0.4
Improvement
Worsening
p lt 0.05, p lt 0.10
Doody et al., Dement Geriatr Cogn Disord 2004
4
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
-0.6
-0.4
-0.2
0
0.2
-0.8
0.4
Improvement
Worsening
Doody et al., Dement Geriatr Cogn Disord 2004
5
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 Toilet
ting Walking Eating
? Memantine ? Placebo
-0.6
-0.4
-0.2
0
0.2
-0.8
0.4
Improvement
Worsening
Doody et al., Dement Geriatr Cogn Disord 2004
6
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
-0.6
-0.4
-0.2
0
0.2
-0.8
0.4
Improvement
Worsening
p lt 0.05, p lt 0.10
Doody et al., Dement Geriatr Cogn Disord 2004
7
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
-0.2
-0.4
-0.6
-0.8
0.2
Improvement
p lt 0.05
Doody et al., Dement Geriatr Cogn Disord 2004
8
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-waki
ng rhythm Behaviour


? Memantine ? Placebo
0
-0.2
-0.4
-0.6
-0.8
0.2
Improvement
p lt 0.10
Doody et al., Dement Geriatr Cogn Disord 2004
9
Summary

• The ADL single item analyses consistently confirm
  that memantine monotherapy provides significant
  benefits on functional abilities for patients
  with moderate to severe Alzheimers 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.