P1‐254: Memantine for depression symptoms in dementia: A feasibility meta‐analytic examination of the evidence from trials for behavioral symptoms.
Bibliographic record
Abstract
Moderate-affinity, uncompetitive N-methyl-D-aspartate receptor antagonist, memantine is one of the compounds suggested by the FDA for management of behavioral symptoms in dementia. The effectiveness of this compound specifically for depressive symptoms in dementia has not systematically been evaluated. There is currently no consensus regarding memantine's utility in the treatment of depression symptoms. Hence, the current study was to examine the evidence of memantine's utility in the management of depression symptoms co-occurring with dementia. A systematic search of the electronic literature (PubMed & EMBASE) for meta-analytic purposes was carried out using an a priori set of inclusion and exclusion criteria using specific key terms, and limiting to human subject and clinical trials. There were 83 abstracts from PubMed and 294 from EMBASE. After removing duplicates and applying selection criteria, seven studies (n = 7) met our criteria. Among those, five prospective longitudinal randomized original studies (n ranging from 20 to 288) and two pooled studies were identified. For the 5 original studies, memantine dosage ranged from 10 to 30 mg/day. Large methodological heterogeneity was observed with respect to a) the scales used for assessment of depressive/affective symptoms [Gottfried-Brane-Steen Scale (affect), Sandoz Clinical assessment Geriatric (affect), Neuropsychiatric inventory (depression/dysphoria)]; b) duration of trials (35 days to 52 weeks); c) diagnosis of dementia in terms of criteria and sample (including both VaD, and AD). Additionally, substantial gender differences were observed between treatment and control/placebo groups, and within the treatment groups (ranging from 30-72% female). Generally, outcomes were reported by means of graphical representation rather than descriptive statistics. However, beyond meta-analytic examination, of the original studies, 2 reported significant difference favoring treatment, and 2 reports no differences between groups, and one did not report item results. Pooled studies report a trend toward amelioration in depressive symptoms in treated group. The evidence that we have collected on the utility of memantine for depressive symptoms in dementia is not adequate for meta-analytic examination. The potential benefits of memantine for depression in dementia remain uncertain. Future research will benefit from using a harmonized approach to the diagnosis of dementia and the assessment of depression in dementia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.030 | 0.057 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.048 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".