Effect of long-term treatment with memantine on mortality in patients with major cognitive disorders: A systematic review and meta-analysis

IF 6.8 Q1 CLINICAL NEUROLOGY Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2025-04-19 DOI:10.1002/trc2.70071

Victoria Zolnowski-Kolp, Bruno Oquendo, Charlotte Havreng-Théry, Carmelo Lafuente-Lafuente, Joël Belmin

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Abstract

BACKGROUND

Dementia is responsible for a reduction in life expectancy, and the effect of memantine on mortality is still poorly understood. Our aim was to evaluate the effect of long-term treatment with memantine on all-cause mortality.

METHODS

In this systematic review and meta-analysis, we searched five databases from their creation to June 2024.

RESULTS

We found 12 randomized trials (n = 4266) and 7 observational studies (n = 20,216). Treatment with memantine was associated with a reduction in all-cause mortality (risk ratios [RRs] 0.81, 95% CI: 0.72–0.92, p = 0.001). In the sensitivity analysis, the pooled RR was similar for randomized controlled trials (RCT) (RR 0.86) and non-randomized studies (RR 0.81) but pooled results from RCTs did not reach statistical significance (95% confidence interval [CI]: 0.59–1.26, p = 0.45), while they did for observational studies (95% CI: 0.70–0.95, p = 0.008), so we consider the overall evidence as of low certainty.

CONCLUSION

Our results suggest that the use of memantine in patients with dementia may be associated with a reduction in all-cause mortality.

Highlights

Dementia reduces patients’ survival and the effect of long-term use of memantine on all-cause mortality is not well known.
This systematic review and metanalysis included 19 studies including more than 24000 patients.
We found that memantine in patients with dementia may be associated with a reduction in all-cause mortality.

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长期使用美金刚对严重认知障碍患者死亡率的影响：一项系统回顾和荟萃分析

背景：痴呆症是预期寿命降低的原因，美金刚对死亡率的影响仍然知之甚少。我们的目的是评估长期使用美金刚治疗对全因死亡率的影响。方法：在这项系统综述和荟萃分析中，我们检索了5个数据库，从其创建到2024年6月。结果纳入12项随机试验（n = 4266）和7项观察性研究（n = 20216）。美金刚治疗与全因死亡率降低相关（风险比[rr] 0.81, 95% CI: 0.72-0.92, p = 0.001）。在敏感性分析中，随机对照试验（RCT）和非随机研究的合并RR相似（RR 0.86），但RCT的合并结果未达到统计学意义（95%置信区间[CI]: 0.59-1.26, p = 0.45），而观察性研究的合并结果达到统计学意义（95% CI: 0.70-0.95, p = 0.008），因此我们认为整体证据的确定性较低。结论：我们的研究结果表明，在痴呆患者中使用美金刚可能与全因死亡率的降低有关。老年痴呆症降低患者生存率，长期使用美金刚对全因死亡率的影响尚不清楚。该系统综述和荟萃分析纳入了19项研究，包括24000多名患者。我们发现，痴呆患者使用美金刚可能与全因死亡率的降低有关。

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来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.