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Domain-specific improvement of cognition on memantine in patients with Alzheimer's disease treated with rivastigmine.
Dement Geriatr Cogn Disord. 2007; 23(5):301-6.DG

Abstract

OBJECTIVE

Cholinergic therapy is used in mild-to-moderate Alzheimer's disease (AD) and antiglutamatergic therapy in moderate-to-severe AD. Global scales, as commonly used in clinical trials, blur specifics of disease progression and drug effects. The objective was to assess combination therapy of rivastigmine plus memantine by specific neuropsychological tests in patients with mild-to-moderate AD.

METHODS

12-week-short multicenter open-label pilot study. Ninety patients with mild-to-moderate AD already on stable medication with rivastigmine (3-6 mg b.i.d.) additionally received memantine for 12 weeks. Subscales of the Alzheimer's Disease Assessment Scale (ADAS-cog), the Mini-Mental State Examination (MMSE) and additional neuropsychological tests (e.g. span tasks, semantic fluency) were assessed.

RESULTS

The scores in the ADAS-cog memory subscale, the MMSE score, and digit span and semantic fluency significantly improved on combination therapy.

CONCLUSION

Memory improvement was correlated with ADAS-cog memory score at baseline and inversely with age at onset of treatment. The data suggest that improvement on combination therapy results from an improvement of attention/executive function with secondary memory improvement, which will need to be confirmed in a subsequent double-blind study on a larger number of patients.

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Authors+Show Affiliations

Riepe MW
Department of Psychiatry, Charité Universitatsmedizin Berlin, Berlin, Germany. matthias.riepe@charite.de
Adler G
No affiliation info available
Ibach B
No affiliation info available
Weinkauf B
No affiliation info available
Tracik F
No affiliation info available
Gunay I
No affiliation info available

MeSH

AgedAged, 80 and overAlzheimer DiseaseAttentionCholinesterase InhibitorsCognitionCognition DisordersDrug Therapy, CombinationExcitatory Amino Acid AntagonistsFemaleHumansMaleMemantineMemoryPhenylcarbamatesPilot ProjectsReceptors, N-Methyl-D-AspartateRivastigmineSeverity of Illness IndexTreatment Outcome

Pub Type(s)

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

Language

eng

PubMed ID

17356273

Citation

Riepe, Matthias W., et al. "Domain-specific Improvement of Cognition On Memantine in Patients With Alzheimer's Disease Treated With Rivastigmine." Dementia and Geriatric Cognitive Disorders, vol. 23, no. 5, 2007, pp. 301-6.
Riepe MW, Adler G, Ibach B, et al. Domain-specific improvement of cognition on memantine in patients with Alzheimer's disease treated with rivastigmine. Dement Geriatr Cogn Disord. 2007;23(5):301-6.
Riepe, M. W., Adler, G., Ibach, B., Weinkauf, B., Tracik, F., & Gunay, I. (2007). Domain-specific improvement of cognition on memantine in patients with Alzheimer's disease treated with rivastigmine. Dementia and Geriatric Cognitive Disorders, 23(5), 301-6.
Riepe MW, et al. Domain-specific Improvement of Cognition On Memantine in Patients With Alzheimer's Disease Treated With Rivastigmine. Dement Geriatr Cogn Disord. 2007;23(5):301-6. PubMed PMID: 17356273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Domain-specific improvement of cognition on memantine in patients with Alzheimer's disease treated with rivastigmine. AU - Riepe,Matthias W, AU - Adler,Georg, AU - Ibach,Bernd, AU - Weinkauf,Birgit, AU - Tracik,Ferenc, AU - Gunay,Ibrahim, Y1 - 2007/03/13/ PY - 2006/09/12/received PY - 2007/3/16/pubmed PY - 2007/6/21/medline PY - 2007/3/16/entrez SP - 301 EP - 6 JF - Dementia and geriatric cognitive disorders JO - Dement Geriatr Cogn Disord VL - 23 IS - 5 N2 - OBJECTIVE: Cholinergic therapy is used in mild-to-moderate Alzheimer's disease (AD) and antiglutamatergic therapy in moderate-to-severe AD. Global scales, as commonly used in clinical trials, blur specifics of disease progression and drug effects. The objective was to assess combination therapy of rivastigmine plus memantine by specific neuropsychological tests in patients with mild-to-moderate AD. METHODS: 12-week-short multicenter open-label pilot study. Ninety patients with mild-to-moderate AD already on stable medication with rivastigmine (3-6 mg b.i.d.) additionally received memantine for 12 weeks. Subscales of the Alzheimer's Disease Assessment Scale (ADAS-cog), the Mini-Mental State Examination (MMSE) and additional neuropsychological tests (e.g. span tasks, semantic fluency) were assessed. RESULTS: The scores in the ADAS-cog memory subscale, the MMSE score, and digit span and semantic fluency significantly improved on combination therapy. CONCLUSION: Memory improvement was correlated with ADAS-cog memory score at baseline and inversely with age at onset of treatment. The data suggest that improvement on combination therapy results from an improvement of attention/executive function with secondary memory improvement, which will need to be confirmed in a subsequent double-blind study on a larger number of patients. SN - 1420-8008 UR - https://www.unboundmedicine.com/medline/citation/17356273/Domain_specific_improvement_of_cognition_on_memantine_in_patients_with_Alzheimer's_disease_treated_with_rivastigmine_ L2 - https://www.karger.com?DOI=10.1159/000100875 DB - PRIME DP - Unbound Medicine ER -