A Systematic Review and Meta-Analysis of the Effectiveness of Acetylcholinesterase Inhibitors and Memantine in Treating the Cognitive Symptoms of Dementia

• Published in: Dementia and geriatric cognitive disorders Vol. 45; no. 3-4; p. 131
• Main Authors: Knight, Ruth, Khondoker, Mizanur, Magill, Nicholas, Stewart, Robert, Landau, Sabine
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2018
• Subjects: Alzheimer Disease - drug therapy; Alzheimer Disease - psychology; Cholinesterase Inhibitors - pharmacology; Cognition - drug effects; Dementia, Vascular - drug therapy; Dementia, Vascular - psychology; Dopamine Agents - pharmacology; Humans; Memantine - pharmacology; Treatment Outcome; Systematic review; Acetylcholinesterase inhibitor; Memantine; Vascular dementia; Alzheimer disease; Meta-analysis
• ISSN: 1421-9824
• DOI: 10.1159/000486546

Acetylcholinesterase inhibitors (AChEIs) and memantine are commonly used in the management of dementia. In routine clinical practice, dementia is often monitored via the Mini-Mental State Examination (MMSE). We conducted a systematic review and meta-analysis of the effects of these drugs on MMSE scores. Eighty trials were identified. Pooled effect estimates were in favour of both AChEIs and memantine at 6 months. Meta-regression indicated that dementia subtype was a moderator of AChEI treatment effect, with the effect of treatment versus control twice as high for patients with Parkinson disease dementia/ dementia with Lewy bodies (2.11 MMSE points at 6 months) as for patients with Alzheimer disease/vascular dementia (0.91 MMSE points at 6 months). Key Messages: AChEIs demonstrate a modest effect versus control on MMSE scores which is moderated by dementia subtype. For memantine the effect is smaller.