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Related Concept Videos

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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Related Experiment Video

Updated: Jan 2, 2026

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Are large simple trials for dementia prevention possible?

William N Whiteley1,2, Sonia Anand3, Shrikant I Bangdiwala3

  • 1Centre for Clinical Brain Sciences, University of Edinburgh, UK.

Age and Ageing
|December 13, 2019
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Summary

Large, simple trials are essential for dementia prevention research. Focusing on functional outcomes and diagnoses, these studies require significant collaboration to overcome challenges in participant numbers and follow-up duration.

Keywords:
dementiaepidemiologyfunctionolder peopletrials

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Area of Science:

  • Neuroscience and Public Health
  • Clinical Trial Design

Background:

  • Dementia prevention research requires novel strategies and agents.
  • Large, simple cardiovascular trials offer a successful model for discovering treatments with moderate effects.
  • Lessons from cardiovascular trial design can inform dementia prevention studies.

Purpose of the Study:

  • To outline suitable populations, interventions, and outcomes for large simple trials in dementia prevention.
  • To identify features necessary for maximizing the efficiency of dementia prevention trials.
  • To address the challenges of participant size and follow-up duration in dementia prevention research.

Main Methods:

  • Consideration of diverse populations, including those selected by age, clinical or genetic risk factors, or clinical presentation.
  • Prioritization of functional and clinical outcomes, as well as dementia diagnoses, over cognitive scores and biomarker levels.
  • Adaptation of large, simple trial designs, proven effective in cardiovascular research, for dementia prevention.

Main Results:

  • Functional and clinical outcomes, including loss of function or dementia diagnoses, are meaningful measures for participants and can be assessed in large trials.
  • Suitable populations can be identified through various demographic, clinical, and genetic criteria.
  • Efficiency in large simple trials can be maximized by careful selection of populations, interventions, and outcomes.

Conclusions:

  • Large simple trials are a viable and necessary approach for dementia prevention research.
  • Participant and patient priorities for functional and clinical outcomes should guide trial design.
  • Overcoming challenges in participant numbers and follow-up duration necessitates extensive collaboration among investigators, funders, and patient organizations.