Comparative assessment of donepezil memantine and sodium oligomannate on cognitive decline and neuroinflammation in early Alzheimer's disease

Abstract

Background: Early Alzheimer's disease (AD) treatments include donepezil, memantine and sodium oligomannate, but their comparative effects on cognitive decline and neuroinflammation are understudied. Objectives: This study compares three drugs' validity in improving two aspects in early AD patients. Methods: 132 early AD patients from XX Hospital (Jan 2022–Dec 2024) were retrospectively included. After exclusion, 126 patients were divided into 3 groups (42 each): Group A (donepezil), Group B (memantine), Group C (sodium oligomannate). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Alzheimer's Disease Assessment Scale--Cognitive Subscale (ADAS-cog), the Activity of Daily Living Scale (ADL), the Montreal Cognitive Assessment Scale (MoCA), levels of inflammatory mediators, including Tumour Necrosis Factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), neuronal marker levels including β-Amyloid (1-42) (Aβ42), Total tau protein (T-tau protein) and adverse reaction incidence. Results: After treatment, compared with Group A, Groups B/C had significantly higher MMSE, ADL, MoCA, Aβ42 (all P<0.05) and lower ADAS-cog, TNF-α, IL-6, IL-8, T-tau (all P<0.05); compared with Group B, Group C had no significant difference in MMSE, ADAS-cog, ADL, MoCA (all P>0.05), but higher Aβ42 and lower TNF-α, IL-6, IL-8, T-tau (all P<0.05); adverse reaction incidence did not differ significantly among the three groups (P>0.05). Conclusion: Memantine and sodium oligomannate outperform donepezil in improving cognitive function and neuroinflammation, with sodium oligomannate suggesting the best effect on neuroinflammation. This study provides a scientific basis for optimizing early AD medication.