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Memantine enhances autonomy in moderate to severe Alzheimer's disease.
Int J Geriatr Psychiatry. 2004 May; 19(5):458-64.IJ

Abstract

BACKGROUND

Alzheimer's disease (AD) is the leading cause of dementia and its course renders patients functionally disabled. Memantine is the first drug to demonstrate a clinical benefit in the treatment of patients with moderately-severe to severe AD.

OBJECTIVES

Our objective was to illustrate the benefits of memantine on functional disability.

METHODS

We classified 252 patients from a randomised 28-week clinical trial of memantine vs placebo according to their Activities of Daily Living capabilities measured by the ADCS-ADLsev scale. The scale was divided into two sub-scores: basic and instrumental. The relevance of this classification was validated by comparing clinical and socio-demographic parameters between the different autonomy classes (autonomous and dependent). The effect of memantine was estimated by using a logistic regression model on the autonomy status of patients at week 28, controlling for confounding factors (Observed Cases analysis).

RESULTS

Our results showed that dependent patients (n = 106) had significantly longer disease duration, poorer cognition, greater severity, more behavioural alterations and higher total societal costs compared with autonomous patients (n = 146). When controlling for autonomy and severity at baseline, memantine-treated patients were three times more likely [Odds Ratio (OR) = 3.03; 95% Confidence Intervals (CI) = (1.38, 6.66)] to remain autonomous after 28 weeks. Analysis of the Treated Per Protocol set and the use of Last Observation Carried Forward analyses confirmed this finding.

CONCLUSIONS

Memantine enhances autonomy in patients with moderately-severe to severe AD by increasing the probability of their remaining autonomous, therefore delaying transition to the dependent stage.

Authors+Show Affiliations

Altipharm SA, 15 rue du Louvre, 75001 Paris, France. benoit_rive@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15156547

Citation

Rive, Benoît, et al. "Memantine Enhances Autonomy in Moderate to Severe Alzheimer's Disease." International Journal of Geriatric Psychiatry, vol. 19, no. 5, 2004, pp. 458-64.
Rive B, Vercelletto M, Damier FD, et al. Memantine enhances autonomy in moderate to severe Alzheimer's disease. Int J Geriatr Psychiatry. 2004;19(5):458-64.
Rive, B., Vercelletto, M., Damier, F. D., Cochran, J., & François, C. (2004). Memantine enhances autonomy in moderate to severe Alzheimer's disease. International Journal of Geriatric Psychiatry, 19(5), 458-64.
Rive B, et al. Memantine Enhances Autonomy in Moderate to Severe Alzheimer's Disease. Int J Geriatr Psychiatry. 2004;19(5):458-64. PubMed PMID: 15156547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Memantine enhances autonomy in moderate to severe Alzheimer's disease. AU - Rive,Benoît, AU - Vercelletto,Martine, AU - Damier,Florence Delamarre, AU - Cochran,John, AU - François,Clément, PY - 2004/5/25/pubmed PY - 2004/6/21/medline PY - 2004/5/25/entrez SP - 458 EP - 64 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 19 IS - 5 N2 - BACKGROUND: Alzheimer's disease (AD) is the leading cause of dementia and its course renders patients functionally disabled. Memantine is the first drug to demonstrate a clinical benefit in the treatment of patients with moderately-severe to severe AD. OBJECTIVES: Our objective was to illustrate the benefits of memantine on functional disability. METHODS: We classified 252 patients from a randomised 28-week clinical trial of memantine vs placebo according to their Activities of Daily Living capabilities measured by the ADCS-ADLsev scale. The scale was divided into two sub-scores: basic and instrumental. The relevance of this classification was validated by comparing clinical and socio-demographic parameters between the different autonomy classes (autonomous and dependent). The effect of memantine was estimated by using a logistic regression model on the autonomy status of patients at week 28, controlling for confounding factors (Observed Cases analysis). RESULTS: Our results showed that dependent patients (n = 106) had significantly longer disease duration, poorer cognition, greater severity, more behavioural alterations and higher total societal costs compared with autonomous patients (n = 146). When controlling for autonomy and severity at baseline, memantine-treated patients were three times more likely [Odds Ratio (OR) = 3.03; 95% Confidence Intervals (CI) = (1.38, 6.66)] to remain autonomous after 28 weeks. Analysis of the Treated Per Protocol set and the use of Last Observation Carried Forward analyses confirmed this finding. CONCLUSIONS: Memantine enhances autonomy in patients with moderately-severe to severe AD by increasing the probability of their remaining autonomous, therefore delaying transition to the dependent stage. SN - 0885-6230 UR - https://www.unboundmedicine.com/medline/citation/15156547/Memantine_enhances_autonomy_in_moderate_to_severe_Alzheimer's_disease_ DB - PRIME DP - Unbound Medicine ER -