Memantine + Cholinesterase Inhibitor Improves Daily Life Functions in AD

VANCOUVER, BC—For patients with moderate to severe Alzheimer’s disease, adding memantine to cholinesterase inhibitor treatment can improve daily life task functions, results of a post-hoc pooled factor analysis presented at the 68^th AAN Annual Meeting have shown.

To assess the effects of memantine in combination with cholinesterase inhibitor therapy on daily functioning, “and to assess potential clusters of functional tasks that improved together,” Gustavo Alva, MD, Medical Director of ATP Clinical Research, Costa Mesa, CA, and colleagues analyzed scores from the 19-item Alzheimer’s Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL₁₉) from the pooled patient population of two 24-week, double-blind, placebo-controlled studies, MEM-MD-02 and MEM-MD-50.

In the MEM-MD-02 study, the active treatment was immediate-release memantine 10mg twice daily and, in MEM-MD-50, extended-release memantine 28mg once daily. Patients were randomized to receive either placebo (n=536) or memantine (n=545) on top of background cholinesterase inhibitor. A total of 525 patients who received placebo and 531 who received memantine, were included in the pooled intent-to-treat population.

“After 24 weeks of treatment, the memantine + cholinesterase inhibitor group performed significantly better than patients in the placebo + cholinesterase inhibitor group on the ADCS-ADL₁₉ items of grooming (P<0.001), conversing (P<0.05), and finding belongings (P<0.01),” he reported. “Treatment with memantine + cholinesterase inhibitor resulted in nominal improvements versus placebo + cholinesterase inhibitor in change from baseline for 17 out of 19 items,” he added.

The study also included an ADL factor analysis, which divided the 19 items into four factors, basic ADLs (eating, walking, toileting, bathing, grooming, dressing), instrumental ADLs (using the telephone, watching television conversing, finding belongings, traveling, being left alone), simple praxis (turning faucet on, turning faucet off, turning light on), and complex praxis (clearing the table, obtaining a beverage, disposing of litter, turning light off).

Dr. Alva reported that the memantine + cholinesterase group “performed significantly better” (all P<0.05) than the placebo + cholinesterase inhibitor group “for the factors of basic ADLs, simple praxis, and praxis items requiring visuo-spatial and memory skills.” 

Dr. Alva disclosed honoraria and funding for clinical research from Forest/Actavis/Allergan.