Section: New Results

How many patients are eligible for disease-modifying treatment in Alzheimer’s disease? A French national observational study over 5 years.

Participants : Stéphane Epelbaum [Correspondant] , Claire Paquet, Jacques Hugon, Julien Dumurgier, David Wallon, Didier Hannequin, Thérèse Jonveaux, Annick Besozzi, Stéphane Pouponneau, Caroline Hommet, Frédéric Blanc, Laetitia Berly, Adrien Julian, Marc Paccalin, Florence Pasquier, Julie Bellet, Claire Boutoleau-Bretonniere, Tiphaine Charriau, Olivier Rouaud, Olivier Madec, Aurélie Mouton, Renaud David, Samir Bekadar, Roxanne Fabre, Emmanuelle Liegey, Walter Deberdt, Philippe Robert, Bruno Dubois.

We aimed to study the epidemiology of the prodromal and mild stages of Alzheimer’s disease (AD) patients who are eligible for clinical trials with disease-modifying therapies. We analyzed two large complementary databases to study the incidence and characteristics of this population on a nationwide scope in France from 2014 to 2018. The National Alzheimer Database contains data from 357 memory centres and 90 private neurologists. Data from 2014 to 2018 have been analyzed. Patients, 50–85 years old, diagnosed with AD who had an Mini-Mental State Exam (MMSE) score greater or equal to 20 were included. We excluded patients with mixed and non-AD neurocognitive disorders. Descriptive statistics of the population of interest was the primary measure. Results In the National Alzheimer Database, 550,198 patients were assessed. Among them, 72,174 (13.1%) were diagnosed with AD and had an MMSE greater or equal to 20. Using corrections for specificity of clinical diagnosis of AD, we estimated that about 50,000 (9.1%) had a prodromal or mild AD. In the combined electronic clinical records database of 11 French expert memory centres, a diagnosis of prodromal or mild AD, certified by the use of cerebrospinal fluid AD biomarkers, could be established in 195 (1.3%) out of 14 596 patients. AD was not frequently diagnosed at a prodromal or mild dementia stage in France in 2014 to 2018. Diagnosis rarely relied on a pathophysiological marker even in expert memory centres. National databases will be valuable to monitor early stage AD diagnosis efficacy in memory centres when a disease-modifying treatment becomes available. More details in [15]