Memantine in Vascular Dementia Möbius H.J. and Stöffler A. International Psychogeriatrics 2003, 15 Suppl 1:

Analyses based on studies in patients with mild to moderate vascular dementia: Orgogozo et al. (2002) (MMM300) Wilcock et al. (2002) (MMM500) ADAS-cog analysis by severity at baseline: MMSE MMSE MMSE ADAS-cog analysis by neuroradiological findings at baseline: Macrolesions, “Large Vessel Disease” No macrolesions, “Small Vessel Disease” Memantine in Vascular Dementia: Subgroup Analyses Möbius and Stöffler, Int Psychogeriatr 2003

Patients with “Large Vessel Disease” Hardly Show Cognitive Decline Möbius and Stöffler, Int Psychogeriatr 2003 ADAS-cog score difference ADAS-cog mean change from baseline ITT, LOCF, N = 214 Improvement Worsening Memantine (20 mg/day) Placebo Week Pooled data

Significant Benefit of Memantine in Patients with “Small Vessel Disease” ADAS-cog score difference Möbius and Stöffler, Int Psychogeriatr 2003 * p = versus placebo ADAS-cog mean change from baseline ITT, LOCF, N = 553 Improvement Worsening Memantine (20 mg/day) Placebo * Week Pooled data

Largest Benefit of Memantine in More Severely Demented Patients Möbius and Stöffler, Int Psychogeriatr 2003 ADAS-cog score difference MMM500MMM Mean ADAS-cog change from baselineITT, LOCF Memantine (20 mg/day) Placebo MMSE at baseline Improvement Worsening

Summary The strongest effect of memantine on cognition was shown in the moderately demented patient population (MMSE < 15 at baseline) and in the subgroup of patients with “small vessel disease” (no macrolesions in CT/MRI) Möbius and Stöffler, Int Psychogeriatr 2003