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P4‐285: Impact on outcomes of adding memantine to donepezil among patients with Alzheimer's disease
Author(s) -
Ramasamy Abhilasha,
Aubert Ron,
Khalid Mona,
Dixit Shailja,
Lateiner Jordan E.,
Epstein Robert S.,
Stern Yaakov
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.2015.08.115
Subject(s) - donepezil , memantine , hazard ratio , medicine , dementia , cognitive decline , proportional hazards model , confidence interval , psychology , psychiatry , disease
(defined as body mass index 30), 32.3% had one or more other cardiovascular conditions (defined as history of heart attack, pacemaker, or valve replacement), 28.5% had atrial fibrillation (afib), 19.3% reported type 2 diabetes, and 8.5% survived stroke. The cognitive battery, which included the MoCA, CERAD Word List Learning and Recall, and Trails B, was administrated by trained psychometrists (Hayden et al., 2014). Results: Mean age was 7265 years (from 56 to 90), 77.1% were female. Age (r1⁄40.338,p<0.001) and education (r1⁄4+0.422,p<0.001) significantly influenced MoCA total score, but male and female subjects performed similarly. A series of multiple regressions were conducted to determinewhether vascular disease predictedMoCA scores after controlling for covariates of age and education. Health variables significantly predicted MoCA total scores, F(9, 1837) 1⁄4 67.80, MoCA percent retention memory scores, F(9,1828) 1⁄4 11.662, and MoCA executive function scores, F(9, 1837) 1⁄4 35.33, all models were significant at p<0.001. However, only afib (b1⁄40.05, p<0.05) and stroke (b1⁄4-0.05, p<0.05) individually predicted MoCA total scores, diabetes (b1⁄4-0.05, p<0.05) predicted poorer memory performance (determined as percent retention), and afib (b1⁄4-0.08, p<0.001) predicted poor executive function. Conclusions:As expected, diabetes, afib and other cardiovascular and cerebrovascular conditions and risk factors were prevalent in this Russian urban elderly population. Vascular risk factors differentially predicted cognitive domains, suggesting differential effects of these risk factors within discrete brain systems. These results indicate that timely treatment and effective control of certain vascular risk factors may help maintain cognition in later life.