Using Nonamnestic Cognitive Symptoms to Predict Trajectories of Neurodegenerative Disorders: Jagan A. Pillai, MD, PhD

WATCH TIME: 3 minutes

Understanding patients’ functional decline trajectory remains an important, but challenging, proposition when constructing clinical trial designs. A recently conducted retrospective longitudinal cohort study examined the differences of initial presenting cognitive symptoms in patients with primary Alzheimer disease pathology (ADP; n = 1190), Lewy body-related pathology (LRP; n = 332), and mixed AD-LRP neuropathologies (n = 904). Types of symptoms observed included those of amnestic, executive, language, and visuospatial nature.

Using Clinical Dementia Rating-Sum of Boxes (CDR-SB) score, results showed that initial nonamnestic symptoms had a faster rate of functional decline than amnestic symptoms across neuropathologies. Given a 1.85 slope for nonamnestic symptoms, a 10% increase in the number of these patients would increase the change in CDR-SB at 2 years by 0.07 points. Presented at the 2022 Alzheimer’s Association International Conference (AAIC), July 31 to August 4, in San Diego, California, the study highlights the need to identify initial symptoms of these patients, as it may have clinical relevance for the future of therapeutics.¹

Lead investigator Jagan A. Pillai, MD, PhD, neurologist, Lou Ruvo Center for Brain Health, Cleveland Clinic, sat down with NeurologyLive^® to discuss the specific differences in initial symptoms, aspects the investigators were keying in on, and how the findings impact future clinical trials.

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REFERENCE
1. Pillai JA, Bena J, Leverenz JB. Non-amnestic initial symptoms have faster trajectories of clinical progression than amnestic symptoms in Alzheimer’s, Lewy body and mixed dementia neuropathologies. Presented at: 2022 Alzheimer’s Association International Conference; July 31 to August 4; San Diego, CA. 66804