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Activities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment.
Alzheimer Dis Assoc Disord 2006 Oct-Dec; 20(4):263-8AD

Abstract

In moderate-to-severe Alzheimer disease (AD), there are significant losses of activities of daily living (ADL). In a recent prospective, randomized, placebo-controlled trial, memantine treatment lessened the overall functional decline in AD patients already on stable donepezil therapy. In this trial, patients (n=404) with Mini-Mental State Examination scores of 5 to 14 receiving stable donepezil treatment were randomized to double-blind treatment with memantine (10 mg b.i.d.; n=203) or placebo (n=201). A primary outcome measure was the 19-item Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory (ADCS-ADL(19)). To further evaluate the treatment effects of memantine on function, we performed post hoc analyses of ADCS-ADL(19) data from this trial, including ADL items and new subscales derived from factor analysis. Using mixed model analyses, patients receiving memantine had statistically significant less decline in total ADCS-ADL(19) scores compared with placebo. An item analysis revealed statistically significant benefits of memantine on grooming, toileting, conversing, watching television, and being left alone. Statistically significant improvements were noted in subscales evaluating higher-level functions and connectedness/autonomy with memantine compared with placebo. These post hoc analyses in moderate-to-severe AD patients receiving stable donepezil treatment suggest that memantine may impact overall functional levels, and some of the cognitive processing underlying ADL performance.

Authors+Show Affiliations

Division of Neurology, University of British Columbia, Vancouver, BC, Canada. hfeldman@interchange.ubc.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17132971

Citation

Feldman, Howard H., et al. "Activities of Daily Living in Moderate-to-severe Alzheimer Disease: an Analysis of the Treatment Effects of Memantine in Patients Receiving Stable Donepezil Treatment." Alzheimer Disease and Associated Disorders, vol. 20, no. 4, 2006, pp. 263-8.
Feldman HH, Schmitt FA, Olin JT, et al. Activities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment. Alzheimer Dis Assoc Disord. 2006;20(4):263-8.
Feldman, H. H., Schmitt, F. A., & Olin, J. T. (2006). Activities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment. Alzheimer Disease and Associated Disorders, 20(4), pp. 263-8.
Feldman HH, et al. Activities of Daily Living in Moderate-to-severe Alzheimer Disease: an Analysis of the Treatment Effects of Memantine in Patients Receiving Stable Donepezil Treatment. Alzheimer Dis Assoc Disord. 2006;20(4):263-8. PubMed PMID: 17132971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Activities of daily living in moderate-to-severe Alzheimer disease: an analysis of the treatment effects of memantine in patients receiving stable donepezil treatment. AU - Feldman,Howard H, AU - Schmitt,Frederick A, AU - Olin,Jason T, AU - ,, PY - 2006/11/30/pubmed PY - 2007/2/14/medline PY - 2006/11/30/entrez SP - 263 EP - 8 JF - Alzheimer disease and associated disorders JO - Alzheimer Dis Assoc Disord VL - 20 IS - 4 N2 - In moderate-to-severe Alzheimer disease (AD), there are significant losses of activities of daily living (ADL). In a recent prospective, randomized, placebo-controlled trial, memantine treatment lessened the overall functional decline in AD patients already on stable donepezil therapy. In this trial, patients (n=404) with Mini-Mental State Examination scores of 5 to 14 receiving stable donepezil treatment were randomized to double-blind treatment with memantine (10 mg b.i.d.; n=203) or placebo (n=201). A primary outcome measure was the 19-item Alzheimer's Disease Cooperative Study--Activities of Daily Living Inventory (ADCS-ADL(19)). To further evaluate the treatment effects of memantine on function, we performed post hoc analyses of ADCS-ADL(19) data from this trial, including ADL items and new subscales derived from factor analysis. Using mixed model analyses, patients receiving memantine had statistically significant less decline in total ADCS-ADL(19) scores compared with placebo. An item analysis revealed statistically significant benefits of memantine on grooming, toileting, conversing, watching television, and being left alone. Statistically significant improvements were noted in subscales evaluating higher-level functions and connectedness/autonomy with memantine compared with placebo. These post hoc analyses in moderate-to-severe AD patients receiving stable donepezil treatment suggest that memantine may impact overall functional levels, and some of the cognitive processing underlying ADL performance. SN - 0893-0341 UR - https://www.unboundmedicine.com/medline/citation/17132971/Activities_of_daily_living_in_moderate_to_severe_Alzheimer_disease:_an_analysis_of_the_treatment_effects_of_memantine_in_patients_receiving_stable_donepezil_treatment_ L2 - http://dx.doi.org/10.1097/01.wad.0000213859.35355.59 DB - PRIME DP - Unbound Medicine ER -