Related Experiment Video
Updated: Jul 5, 2026
An Intestine/Liver Microphysiological System for Drug Pharmacokinetic and Toxicological Assessment
Published on: December 3, 2020
Measuring clinically relevant change in apathy symptoms in ADMET and ADMET 2
Shankar Tumati1, Nathan Herrmann1, Jaime Perin2
1Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.
Objectives:
Among participants with Alzheimer's disease (AD) we estimated the minimal clinically important difference (MCID) in apathy symptom severity on three scales.
Design:
Retrospective anchor- and distribution-based analyses of change in apathy symptom scores.
Setting:
Apathy in Dementia Methylphenidate Trial (ADMET) and ADMET 2 randomized controlled trials conducted at three and ten clinics specialized in dementia care in United States and Canada, respectively.
Participants:
Two hundred and sixty participants (60 ADMET, 200 ADMET 2) with clinically significant apathy in Alzheimer's disease.
Measurements:
The Clinical Global Impression of Change in Apathy scale was used as the anchor measure and the MCID on the Neuropsychiatric Inventory - Apathy (NPI-A), Dementia Apathy Interview and Rating (DAIR), and Apathy Evaluation Scale-Informant (AES-I) were estimated with linear mixed models across all study visits. The estimated thresholds were evaluated with performance metrics.
Results:
Among the MCID was a decrease of four points (95% CI: -4.0 to -4.8) on the NPI-A, 0.56 points (95% CI: -0.47 to -0.65) on the DAIR, and three points on the AES-I (95% CI: -0.9 to -5.4). Distribution-based analyses were largely consistent with the anchor-based analyses. The MCID across the three measures showed ∼60% accuracy. Sensitivity analyses found that MMSE scores and apathy severity at baseline influenced the estimated MCID.
Conclusions:
MCIDs for apathy on three scales will help evaluate treatment efficacy at the individual level. However, the modest correspondence between MCID and clinical impression of change suggests the need to consider other scales.
Insights
Researchers estimated the minimal clinically important difference (MCID) for apathy in Alzheimer's disease (AD) patients. Findings provide benchmarks for evaluating apathy treatment efficacy using the NPI-A, DAIR, and AES-I scales.
Area of Science:
- Neuroscience
- Gerontology
- Psychiatry
Background:
- Apathy is a common and debilitating symptom in Alzheimer's disease (AD).
- Accurate measurement of apathy symptom severity is crucial for assessing treatment effectiveness.
- Establishing minimal clinically important differences (MCIDs) provides a benchmark for meaningful change.
Purpose of the Study:
- To estimate the MCID for apathy symptom severity in individuals with Alzheimer's disease.
- To determine MCIDs on three distinct apathy assessment scales: NPI-A, DAIR, and AES-I.
- To evaluate the consistency of MCID estimates using both anchor-based and distribution-based methods.
Main Methods:
- Retrospective analysis of data from the Apathy in Dementia Methylphenidate Trial (ADMET and ADMET 2).
- Utilized anchor-based methods with the Clinical Global Impression of Change in Apathy scale.
- Employed distribution-based analyses and linear mixed models to estimate MCIDs on NPI-A, DAIR, and AES-I.
Main Results:
- Estimated MCIDs were: -4.0 points on NPI-A, -0.56 points on DAIR, and -3.0 points on AES-I.
- Anchor-based and distribution-based analyses yielded consistent results.
- MCID estimates demonstrated approximately 60% accuracy, with baseline MMSE scores and apathy severity influencing results.
Conclusions:
- The established MCIDs offer valuable thresholds for assessing the efficacy of interventions targeting apathy in Alzheimer's disease at an individual level.
- The moderate agreement between MCID and clinical impression highlights the need for careful interpretation and consideration of multiple assessment tools.
- Further research may be needed to refine MCID estimates and explore their clinical utility across diverse patient populations.
More Related Videos
05:48The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
10:02Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
Published on: March 12, 2020
Related Concept Videos
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
01:22Alzheimer's Disease: Treatment
01:20Measurement of Bioavailability: Pharmacodynamic Methods
01:24Chronic Kidney Disease II: Clinical Manifestations
01:24Automated Microbial Diagnostics