Objective:

To evaluate whether using donepezil and memantine together improves cognitive function, daily living activities, and quality of life in people with moderate to severe Alzheimer’s disease.

Background:

Alzheimer’s disease (AD) is the most common cause of dementia. It leads to ongoing loss of memory and daily function. Using donepezil and memantine together has been tested as a treatment for people with moderate to severe AD.

Design/Methods:

A review and meta-analysis were done using studies from PubMed and Cochrane between 2014 and 2024. The search used the words “Alzheimer’s disease,” “donepezil,” “memantine,” and “combination therapy.” Main outcomes included memory and thinking scores (MMSE, SMMSE), behavior symptoms (NPI), daily living ability (ADL), quality of life (QoL), hospital visits, and cost. The data were combined using a random-effects model, and differences between studies were checked with the I² statistic.

Results:

Ten studies were included. The combination treatment improved memory and thinking, with a pooled MMSE increase of 1.44 (95% CI: [0.35, 2.53], P = 0.009). There was high variation between studies (I² = 78%). Behavior symptoms got better, with an NPI change of -3.35 (95% CI: [-6.76, 0.06], P = 0.05). ADL scores showed small gains but were not significant. The treatment lowered hospital visits by 25.5% and raised five-year survival by 8.3%. This also led to cost savings. Some studies found better quality of life, but data were limited.

Conclusions:

Using donepezil and memantine together helps with memory and may cut healthcare costs for people with moderate to severe AD. It also seems to reduce hospital visits. More research is needed to confirm effects on quality of life.