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P4‐394: Lack of evidence for the efficacy of memantine in mild Alzheimer's disease and modest effects in moderate Alzheimer's disease
Author(s) -
Schneider Lon S.,
Dagerman Karen,
Shaikh Zakaria
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.2464
Subject(s) - memantine , placebo , medicine , clinical trial , randomized controlled trial , alzheimer's disease , disease , dementia , pathology , alternative medicine
is over 6,600 men in the U.S., Canada, and Puerto Rico in collaboration with the NCI-sponsored prostate prevention study. The accuracy of the primary, brief memory screening tool is critical for identifying possible incident cases of dementia, and triggers a second-level mental status exam that can trigger a medical evaluation for AD. Objectives: (1) Provide validation results for screening tools from a prevention trial. (2) Compare results of the Memory Impairment Screen (MIS) to expanded measures of memory. Methods: PREADVISE participants are screened annually with the Memory Impairment Screen (MIS). A Normal Aging (NAG) validation sub-sample is given an expanded battery annually that includes CERAD measures supplemented with tests (e.g., NYU paragraph recall, phonemic fluency, clock drawing). The current analysis evaluates the correspondence between MIS performance and memory scores from 410 men (mean: age 70.6 5.6; education 15.6 2.3; 10% African-American). Results: MIS performance for 84.4% of the sample was 7 or 8 (8 max), while 5.4% scored in the low normal range (5 or 6) and 10.2% scored at or below the cutoff of 4. Age, but not education differed between the 3 MIS groups. ANCOVA’s (age covariate) revealed group differences for multiple expanded memory measures. A follow-up multiple linear regression model shows a statistically significant prediction of MIS scores by measures of recognition errors (false positives) plus category fluency (R 0.59) and delayed recall (10-item word list; NYU paragraph; R 0.10). Conclusions: These data suggest that the 3-minute MIS has utility as a screening tool for prevention trials based on its association with other episodic memory tests. Sensitivity and specificity will be ascertained as more incident AD cases are identified. Further, as PREADVISE progresses, these validation methods can also indicate if the MIS could be improved through the addition of other cognitive components, providing an effective tool for AD detection in general clinical settings.