Memantine for dementia

McShane, Rupert; Westby, Maggie J; Roberts, Emmert; Minakaran, Neda; Schneider, Lon S.; Farrimond, Lucy; Maayan, Nicola; Ware, Jennifer; Debarros, Jean

doi:10.1002/14651858.cd003154.pub5

Cited by 659 publications

(324 citation statements)

References 40 publications

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“…The findings of this recent meta-analysis are not inconsistent with earlier reviews of rivastigmine, galantamine and memantine. Previous Cochrane reviews have concluded that there was insufficient evidence to support the use of these three drugs (galantamine, rivastigmine and memantine) in patients with vascular dementia [39][40][41]. However, results in the meta-analysis for donepezil differ from an earlier review of the Cochrane Database [42] and from a manufacturer-sponsored review [43].…”

Section: Curative Treatmentmentioning

confidence: 94%

Is It Possible to Treat Vascular Dementia?

Zekry¹

2009

Dementia in Clinical Practice

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Randomized controlled trials of primary and secondary prevention of vascular dementia demonstrate real effects on the cause or progression of disease (disease-modifying treatment). These strategies lead to a reduction in all cerebrovascular risk factors, in particular hypertension. Such treatment may prevent dementia by reducing stroke and possibly by other mechanisms that remain undetermined, such as those involved in neurodegeneration and cell death. Curative treatment of vascular dementia, particularly given recent studies on cholinesterase inhibitors (rivastigmine, donepezil and galantamine) and memantine, is still ineffective. There is insufficient evidence to support widespread use of these drugs in vascular dementia. Particular considerations should be taken into account in clinical trials. Vascular dementia is a heterogeneous disease with different subtypes and mechanisms. Therefore, well-designed, adequately powered trials accounting for this heterogeneity, with better clinical definitions and an assessment and detection of cognitive and global changes specific to vascular dementia, are needed.

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Section: Curative Treatmentmentioning

confidence: 94%

Is It Possible to Treat Vascular Dementia?

Zekry¹

2009

Dementia in Clinical Practice

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“…Vascular dementia can be delayed or even prevented by treatment or management of the predisposing vascular factors (Chang-Quan et al 2011;Exalto et al 2012), but currently, there is no available treatment for delaying the onset or the progression of Alzheimer disease. Moreover, the only dementia with specific therapies is the dementia caused by Alzheimer 0 s Disease, and these treatments offer only symptomatic relief (Birks 2006;McShane et al 2006). Thus, dementia is a public health priority, and prevention is an essential strategy to deal with it.…”

Section: Introductionmentioning

confidence: 99%

Genotype patterns at CLU, CR1, PICALM and APOE, cognition and Mediterranean diet: the PREDIMED-NAVARRA trial

et al. 2014

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The traditional Mediterranean diet (MedDiet) has shown beneficial effects on cognitive decline. Nevertheless, diet-gene interactions have been poorly evaluated. We aimed to investigate diet-gene interaction in the PREDIMED-NAVARRA randomized trial. A total of 522 participants (67 ± 6 years at baseline) enrolled in the PREDIMED-NAVARRA trial were randomly allocated to one of three diets: two MedDiets (supplemented with either extra-virgin olive oil or nuts) or a low-fat diet. They were evaluated with the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) after 6.5 years of intervention. Subjects were genotyped for CR1-rs3818361, CLU-rs11136000, PICALM-rs3851179 and Apolipoprotein E (ApoE) genes. We studied MedDietgene interactions for cognition and assessed the effect of the MedDiet on cognition across different genetic profiles. A significant interaction (p = 0.041) between CLUrs11136000 and the MedDiet intervention on the MMSE was found with a beneficial effect of MedDiet among carriers of the T minor allele (B = 0.97, 95 % CI 0.45-1.49). Similar effect was observed for CR1-rs3818361, but no significant interaction was observed (p = 0.335). For PICALM-rs3851179, the MedDiet intervention showed a beneficial effect in both genotype groups. No apparent interaction was found for the CDT between intervention and gene variants. Similarly, participants randomly allocated to MedDiet groups, with favorable 123Genes Nutr (2014) 9:393 DOI 10.1007/s12263-014-0393-7 profiles of CR1, CLU and PICALM genes, significantly improved CDT scores compared to controls with the same genetic profile. Cognitive performance was better for nonApoE4 and for ApoE4 carriers of MedDiet groups compared to controls, but for CDT performance, we only found statistical significant differences for non-ApoE4 carriers. A MedDiet intervention modulates the effect of genetic factors on cognition. The effect of MedDiet might be greater for subjects with a more favorable genetic profile.

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“…10 A metaanalysis of nine studies found that memantine improved cognitive functions, activities of daily living and behavioural disturbance in patients with Alzheimer's dementia. 11 However the effect size is small.…”

Section: Alzheimer's Dementiamentioning

confidence: 99%

“…Two six month studies have shown improvement in cognitive function and reduction of agitation in vascular dementia. 10 Two RCTs have shown small improvement in cognitive functions in vascular dementia. 10 Two RCTs showed memantine to be marginally superior to placebo in the treatment of fronto-temporal dementia as assed by clinical global impression scores.…”

Section: Alzheimer's Dementiamentioning

confidence: 99%