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Memantine led to functional improvement and reduced care dependence in severe dementia
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Question In patients with moderately severe to severe primary dementia, how effective and safe is memantine?

Design

Randomised, double blind, placebo controlled trial with 12 weeks follow up.

Setting

7 trial centres in Latvia.

Patients

167 care dependent inpatients with moderately severe to severe dementia defined by DSM-III-R criteria (49% Alzheimer's disease, 51% vascular dementia) and with severity assessed by the Global Deterioration Scale (stages 5–7) and the Mini-Mental State Examination (<10 points). Exclusion criteria included duration of dementia <12 months; central nervous system active drugs within the previous 14 days; severe, chronic, or terminal diseases; impaired thyroid function, lowered B12 blood concentration; abnormal blood chemistry; alcoholism or drug addiction; major depression; learning disability; epilepsy; and Parkinson's disease. 1 patient was excluded from the analysis.

Intervention

82 patients were assigned to memantine (5 mg/d during the first week and 10 mg/d during the next 11 wks) and 84 to placebo.

Main outcome measures

Clinical Global Impression of Change (CGI-C) rated by the physician, and the Behavioural Rating Scale for Geriatric Patients (BGP), subscore “care dependence,” rated by the nursing staff.

Main results

At 12 …

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