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O1–06–01: Challenges in international clinical trials to delay early symptomatic Alzheimer's disease
Author(s) -
WelshBohmer Kathleen,
Romero Heather,
Hayden Kathleen,
Plassman Brenda,
Germain Cassandra,
Sano Mary,
Espeland Mark,
Craft Suzanne,
Monsch Andreas,
Schneider Lon,
Chiang Carl,
Haneline Stephen,
Oneil Janet,
Malholtra Manoj,
Brannan Stephen,
Burns Daniel,
Roses Allen D.
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.04.079
Subject(s) - clinical dementia rating , operationalization , context (archaeology) , neuropsychology , population , psychology , clinical trial , neuropsychological assessment , dementia , disease , medicine , clinical psychology , cognition , psychiatry , paleontology , philosophy , environmental health , epistemology , biology
odds ranging from 2.4 to 4.99. The pooled adjusted risk ratio was 2.91 (95% confidence interval: 1.51 5.61). Risk estimates were presented in the context of a key confounder-cerebral infarcts-which are more common in those with T2DM and might contribute to the manifestation of clinical AD. We provide evidence from clinico-neuropathologic studies that demonstrates the following: First, those with dementia at postmortem are more likely to have both AD-type and cerebrovascular pathologies. Second, cerebral infarcts are more common than AD-type pathology in those with T2DM and dementia. Finally, cerebral infarcts reduce the number of AD lesions required for the manifestation of clinical dementia, but they do not appear to interact synergistically with AD-type pathology. Conclusions: Therefore, the increased risk of clinically diagnosed AD seems to be mediated through cerebrovascular pathology.