The epidemiology is promising, but the trial evidence is weak. Why pharmacological dementia risk reduction trials haven't lived up to expectations, and where do we go from here?

Ruth Peters, Hiroko H. Dodge, Sarah James, Gregory A. Jicha, Pierre Francois Meyer, Marcus Richards, A. David Smith, Hussein N. Yassine, Erin Abner, Atticus H. Hainsworth, Patrick G. Kehoe, Nigel Beckett, Craig S. Anderson, Kaarin J. Anstey

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

There is an urgent need for interventions that can prevent or delay cognitive decline and dementia. Decades of epidemiological research have identified potential pharmacological strategies for risk factor modification to prevent these serious conditions, but clinical trials have failed to confirm the potential efficacy for such interventions. Our multidisciplinary international group reviewed seven high-potential intervention strategies in an attempt to identify potential reasons for the mismatch between the observational and trial results. In considering our findings, we offer constructive recommendations for the next steps. Overall, we observed some differences in the observational evidence base for the seven strategies, but several common methodological themes that emerged. These themes included the appropriateness of trial populations and intervention strategies, including the timing of interventions and other aspects of trials methodology. To inform the design of future clinical trials, we provide recommendations for the next steps in finding strategies for effective dementia risk reduction.

Original languageEnglish (US)
Pages (from-to)507-512
Number of pages6
JournalAlzheimer's and Dementia
Volume18
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • Alzheimer's disease
  • clinical trials
  • dementia
  • epidemiology

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience

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