Are large simple trials for dementia prevention possible?

William N. Whiteley, Sonia Anand, Shrikant I. Bangdiwala, Jackie Bosch, Michelle Canavan, Howard Chertkow, Hertzel C. Gerstein, Philip Gorelick, Martin O'Donnell, Guillaume Paré, Marie Pigeyre, Sudha Seshadri, Mike Sharma, Eric E. Smith, Jeff Williamson, Tali Cukierman-Yaffe, Robert G. Hart, Salim Yusuf

Research output: Contribution to journalArticle

Abstract

New trials of dementia prevention are needed to test novel strategies and agents. Large, simple, cardiovascular trials have successfully discovered treatments with moderate but worthwhile effects to prevent heart attack and stroke. The design of these trials may hold lessons for the dementia prevention. Here we outline suitable populations, interventions and outcomes for large simple trials in dementia prevention. We consider what features are needed to maximise efficiency. Populations could be selected by age, clinical or genetic risk factors or clinical presentation. Patients and their families prioritise functional and clinical outcomes over cognitive scores and levels of biomarkers. Loss of particular functions or dementia diagnoses therefore are most meaningful to participants and potential patients and can be measured in large trials. The size of the population and duration of follow-up needed for dementia prevention trials will be a major challenge and will need collaboration between many clinical investigators, funders and patient organisations.

Original languageEnglish (US)
Pages (from-to)154-160
Number of pages7
JournalAge and ageing
Volume49
Issue number2
DOIs
StatePublished - Feb 27 2020

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Keywords

  • dementia
  • epidemiology
  • function
  • older people
  • trials

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

Whiteley, W. N., Anand, S., Bangdiwala, S. I., Bosch, J., Canavan, M., Chertkow, H., Gerstein, H. C., Gorelick, P., O'Donnell, M., Paré, G., Pigeyre, M., Seshadri, S., Sharma, M., Smith, E. E., Williamson, J., Cukierman-Yaffe, T., Hart, R. G., & Yusuf, S. (2020). Are large simple trials for dementia prevention possible? Age and ageing, 49(2), 154-160. https://doi.org/10.1093/ageing/afz152