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Canadian Journal of Neurological Sciences Canadian Journal of Neurological Sciences

Article contents

Multiple Pathologies are Common in Alzheimer Patients in Clinical Trials

Published online by Cambridge University Press:  02 December 2014

B. W. Wang ,
E. Lu ,
I. R. A. Mackenzie ,
M. Assaly ,
C. Jacova ,
P. E. Lee ,
B. L. Beattie  and
G. Y. R. Hsiung
B. W. Wang
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
E. Lu
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
I. R. A. Mackenzie
Affiliation:
Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
M. Assaly
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
C. Jacova
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
P. E. Lee
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
B. L. Beattie
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
G. Y. R. Hsiung*
Affiliation:
Department of Medicine, Faculty of Medicine, University of British Columbia
*
Division of Neurology, Room S162, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, V6T 2B5, Canada. Email: hsiung@mail.ubc.ca
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Abstract

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Objective:

To determine the frequency of multiple pathology [Alzheimer Disease (AD) plus Vascular Dementia and/or Dementia with Lewy Bodies] in patients enrolled in clinical trials of AD therapy, and to compare the cognitive and functional assessments between patients with pure AD and AD with multiple pathology.

Methods:

We conducted a retrospective analysis of patients with a clinical diagnosis of AD who were enrolled in AD therapy clinical trials and subsequently received an autopsy for confirmation of their diagnosis from 2000 to 2009. Performance on cognitive screening tests, namely Modified Mini Mental state (3MS) exam, Mini Mental state Exam (MMSE) and Functional Rating Scale (FRS) were compared between patients with pure AD and multiple pathology.

Results:

Autopsy reports were available for 16/47 (34%) of deceased patients. Of these 16 patients, 5 (31%) had pure AD pathology, 10 (63%) had AD with other pathology, and 1 (6%) had non-AD pathology. Compared to patients with pure AD, patients with AD mixed with other pathology had poorer baseline FRS in problem-solving (p<0.01) and community affairs (p<0.02).

Conclusion:

While the strict enrollment criteria for clinical trials identified the presence of AD pathology in the majority of cases (15/16), multiple pathology was more common than pure AD in our series of autopsied patients. Premortem biomarkers that can distinguish between pure AD and AD with multiple pathology will be beneficial in future clinical trials and dementia patient management.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 5 , September 2012 , pp. 592 - 599
Copyright
Copyright © The Canadian Journal of Neurological 2012

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