Premium
P3‐299: Caregiver distress related to neuropsychiatric symptoms is reduced with extended‐release memantine‐cholinesterase inhibitor combination in patients with moderate to severe Alzheimer's disease
Author(s) -
Atri Alireza,
Hendrix Suzanne,
Ellison Noel,
Pejović Vojislav,
Otcheretko Victor
Publication year - 2015
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.2015.06.1672
Subject(s) - memantine , placebo , medicine , distress , cholinesterase , donepezil , psychology , disease , clinical psychology , dementia , alternative medicine , pathology
Objective: In this study, we aimed to explore the effects of the MemER+ChEI combination on caregiver burden by evaluating item-level changes in the caregiver distress component of the NPI (NPI-D).Background:Neuropsychiatric symptoms significantly contribute to caregiver burden in Alzheimers disease (AD). The Neuropsychiatric Inventory (NPI) is a 12-item scale designed to assess the presence, severity, and distressful effects of neuropsychiatric symptoms in AD. In the MEM-MD-50 study, a 24-week, randomized trial in individuals with moderate to severe AD, the combination of extended release memantine (MemER) with cholinesterase inhibitor (ChEI) treatment (MemER+ChEI) was associated with significant benefits versus placebo and ChEI treatment (PBO+ChEI) on several outcome measures, including the NPI.Methods: Score changes from baseline to Weeks 12 and 24 for the NPI-D items and the total score were analyzed for 593 individuals with moderate to severe AD (mean age, 76.2 years; mean MMSE score, 11) using an analysis of covariance (ANCOVA) model without adjustment for multiple comparisons.Results: At Week 12, score changes for 8 out of 12 NPI-D items nominally favored MemER+ChEI over PBO+ChEI. For two of these items the least squares mean difference (LSMD) was statistically significant (agitation: -0.27, P=0.019; delusions, -0.23; P=0.028); the LSMD for total NPI-D score was -0.87 (P=0.074). At Week 24, the LSMDs nominally favored MemER+ChEI for 9 out of 12 items, reaching statistical significance for agitation (-0.29, P=0.025) and nighttime behavior (-0.24, P=0.047). The LSMD for total NPI-D was -1.07 (P=0.069). No differences significantly favored PBO+ChEI.Conclusions: This exploratory post hoc analysis suggests that, in individuals with moderate to severe AD receiving background ChEI therapy, 12- or 24-week treatment with memantine ER may reduce caregiver burden associated with the neuropsychiatric symptoms of AD, particularly those related to agitation, delusions, and nighttime behaviors. Disclosure: Dr. Atri has received personal compensation for activities with Lundbeck. Dr. Hendrix has received personal compensation for activities with Pentara Corporation as an owner/employee. Dr. Ellison has received personal compensation for activities with Pentara Corporation as an employee. Dr. Otcheretko has received personal compensation for activities with Actavis, Inc. and Shire, Inc. Dr. Edwards has received personal compensation for activities with Allergan as an employee.