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When Added to Donepezil Therapy, Memantine Enhances Communication Abilities in Patients With Moderate to Severe Alzheimer's Disease: Presented at AGS

By Crina Frincu-Mallos, PhD

WASHINGTON, DC -- May 5, 2008 -- Memantine significantly improves naming and functional communication skills in patients with Alzheimer's disease, thus facilitating social interaction between patient and caregiver, researchers reported here at the 2008 American Geriatrics Society (AGS) Annual Scientific Meeting.

Results of a post hoc analysis of data from patients with moderate to severe Alzheimer's disease enrolled in the randomised, double-blind MEM-MD-02 trial were presented by lead author Judith Saxton, PhD, Associate Professor of Neurology and Psychiatry, Director, Training and Information Core, and Associate Director, Clinical Core, Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.

Communication difficulties in this patient population are a major source of caregiver burden, so Dr. Saxton and colleagues conducted the study to assess the effects of memantine on various language domains and on daily communication skills.

For 24 weeks, while receiving a stable dose of donepezil, 202 patients were randomised to receive memantine 10 mg twice daily and 201 patients were randomised to receive placebo.

Participants enrolled in this trial had a mean age of 75.5 +- 8.6 years, with a 2:1 ratio of women to men.

The researchers evaluated the mean change from baseline between the memantine/donepezil versus placebo/donepezil groups, looking at the Functional Communication Score at week 24. Data from the observed cases and last observation carried forward (LOCF) cases were analysed using the analysis of covariance model and were used to perform a Wilcoxon-Mann-Whitney test.

At week 24 among observed cases, patients treated with memantine/donepezil showed a significant improvement over the placebo/donepezil group on the Severe Impairment Battery (SIB) subscale of "Naming" (P = .009; LOCF: P = .03). In addition, significant improvement was noticed at weeks 8 (P = .02; LOCF: P = .03) and 12 (P = .003; LOCF: P = .01).

Looking at the Functional Communication Score at week 24 in the observed cases, memantine/donepezil offered significant benefits compared with placebo/donepezil (P = .004; LOCF: P = .02)

In addition, the researchers looked at the proportion of patients taking memantine/donepezil versus placebo/donepezil showing a clinical decline at weeks 12 and 24.

Overall, significantly fewer patients treated with memantine/donepezil experienced a clinical decline on the SIB subscales of "Naming" (P = .01) and "Reading/Writing" (P = .02), and the Functional Communication score (P = .009).

Dr. Saxton and colleagues concluded that memantine, when added to donepezil therapy, significantly improves naming abilities in patients with moderate to severe Alzheimer's disease.

Funding for this study was provided by Forest Research Laboratories.


[Presentation title: Memantine Prevents Worsening of Communication Abilities in Patients With Moderate to Severe Alzheimer's Disease: Mean Change and Responder Analysis. Abstract B119]

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