The post‐modern world of Alzheimer's disease trials: how much is an ADAS‐cog point worth in central London?

Issues in Design and Conduct of Clinical Trials for Cognitive-Enhancing Drugs

“…24, 25 The two cognitive instruments most commonly used in AD trials have been the ADAS-cog and the MMSE. Prevalent thinking is that treatments that improve, or reduce the decline of, cognition would be expected to provide important benefi ts to patients with AD and their caregivers, and that even maintenance of baseline levels of cognitive function should mean an improvement in QoL and autonomy for patients (compared to placebo-treated patients).…”

Efficacy and cost-effectiveness in dementia interventions: the need for an international consensus

“…The publication within the NICE guidelines of very detailed but (in the eyes of some) questionable economic (monetary) modelling in attempting to measure the 'Cost-Effectiveness' of cholinesterase inhibitors to arrive at this set of recommendations has raised important questions [4]. Most fundamentally, it is far from clear how appropriate it is to base cost-effectiveness calculations on quality-adjusted life years (QALYs) in older people with dementia.…”

Predictive Value of 6-Month Decline in ADAS-cog for Survival without Severe Alzheimer’s Disease

“…[6,7] One of the main subjects of controversy is the lack of clinically meaningful information from such a small ADAS-cog gain (or decline) on a 70 point-scale for physicians, patients and caregivers. [8,9] Although statistically significant, the clinical meaning of outcome measures in AD trials needs to be demonstrated. [10] In the Facing Dementia Survey, only 41% of physicians, 30% of caregivers and 24% of the subjects from the general population considered the efficacy of these medications as credible.…”