A systematic review and meta-analysis of the effectiveness of acetylcholinesterase inhibitors and memantine in treating the cognitive symptoms of dementia

Background: 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. Summary: Eighty trials were identified. Pooled effect estimates were in favour of both AChEIs and memantine at 6 months. Meta-regression indicated that dementia sub-type was a moderator of AChEI treatment effect with the effect of treatment versus control twice as high for PDD/DLB patients (2.11 MMSE points at 6 months) as for AD/VaD patients (0.91 MMSE points at 6 months). Key messages: AChEIs demonstrate a modest effect versus control on MMSE scores which is moderated by dementia sub-type. For memantine the effect is smaller.