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P1‐436: Effects of memantine treatment on language abilities and functional communication in patients with moderate‐to‐severe Alzheimer's disease: A review of data
Author(s) -
Tocco Michael,
Graham Stephen M.
Publication year - 2010
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.2010.05.991
Subject(s) - memantine , post hoc analysis , clinical trial , medicine , psychology , repeated measures design , audiology , clinical psychology , disease , dementia , statistics , mathematics
Background: Memantine is an uncompetitive NMDA receptor antagonist, approved in the US, Europe and in many countries worldwide for the treatment of moderate to severe Alzheimer’s disease (AD). Anecdotal clinical reports of improved communication abilities in memantine-treated patients with AD have led investigators to examine the effect of memantine on language in clinical trials. This review summarizes memantine data from several clinical studies in which language and functional communication were examined in patients with moderate to severe AD. Methods: Results of post-hoc analyses and prospectively defined endpoints from double-blind, placebocontrolled trials measuring the effects of memantine treatment on language and functional communication in patients with moderate to severe AD were reviewed. Post-hoc analyses measured patients’ language abilities using the Severe Impairment Battery (SIB) language domain and individual SIB language items, while caregiver ratings of patients’ functional communication were examined by combining communication-related items from the AD Cooperative Study-Activities of Daily Living scale (ADCS-ADL19) and the Behavioral Rating Scale for Geriatric Patients (BGP). Prospectively, language was assessed using the Functional Linguistic Communication Inventory (FLCI) and the Verbal Fluency Test (VFT). Caregiver assessment of functional communication employed the combined subscales of Social Communication and Communication of Basic Needs, from the American SpeechLanguage-Hearing Association Functional Assessment of Communications Skills for Adults (ASHA-FACS). For each measure, change from baseline at study endpoint (Week 12 or 24) and overall was compared between treatment groups using ANCOVA models (LOCF, OC, or MMRM). Results: In the post hoc analyses, memantine-treated patients significantly outperformed placebo-treated patients on the SIB language domain and items, and on the caregiver-informed functional communication measure (ADCS-ADL19/ BGP items). These post hoc findings were consistent with prospectively defined endpoints: patients who received memantine performed better than placebo-treated patients on both patient (FLCI and VFT) and caregiverinformed functional communication measures (ASHA-FACS subscales). Conclusions: A growing body of evidence from multiple trials suggests that, in patients with moderate to severe AD, memantine treatment is associated with improvements in language abilities and functional communication, compared with placebo treatment.