Should EOAD patients be included in clinical trials?
- PMID: 21345175
- PMCID: PMC3109413
- DOI: 10.1186/alzrt63
Should EOAD patients be included in clinical trials?
Abstract
Alzheimer disease (AD) is a devastating neurodegenerative disease affecting 1 in 68 in the population. An arbitrary cutoff 65 years as the age of onset to distinguish between early- and late-onset AD has been proposed and has been used in the literature for decades. As the majority of patients develop AD after 65 years of age, most clinical trials address this population. While the early-onset cases represent only 1% to 6% of AD cases, this population is the active working subset and thus contributes to a higher public health burden per individual, and early-onset cases are the most devastating at the level of the individual and their families. In this review, we compare and contrast the clinical, neuropsychological, imaging, genetic, biomarker, and pathological features of these two arbitrary groups. Finally, we discuss the ethical dilemma of non-abandonment and justice as it pertains to exclusion of the early-onset AD patients from clinical trials.
References
-
- Amaducci LA, Rocca WA, Schoenberg BS. Origin of the distinction between Alzheimer's disease and senile dementia: how history can clarify nosology. Neurology. 1986;36:1497–1499. - PubMed
-
- Campion D, Dumanchin C, Hannequin D, Dubois B, Belliard S, Puel M, Thomas-Anterion C, Michon A, Martin C, Charbonnier F, Raux G, Camuzat A, Penet C, Mesnage V, Martinez M, Clerget-Darpoux F, Brice A, Frebourg T. Early-onset autosomal dominant Alzheimer disease: prevalence, genetic heterogeneity, and mutation spectrum. Am J Hum Genet. 1999;65:664–670. doi: 10.1086/302553. - DOI - PMC - PubMed
-
- Janssen JC, Beck JA, Campbell TA, Dickinson A, Fox NC, Harvey RJ, Houlden H, Rossor MN, Collinge J. Early onset familial Alzheimer's disease: mutation frequency in 31 families. Neurology. 2003;60:235–239. - PubMed
-
- Dominantly Inherited Alzheimer Network homepage. http://www.dian-info.org
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