- Email: [email protected]
AEROBIC EXERCISE, IGF-1 AND COGNITION IN ELDERLY WITH ALZHEIMER’S DISEASE AND NON-DEMENTED ELDERLY
P932
Poster Presentations: Tuesday, July 18, 2017
status (d¼1.41) and lower levels of stress (d¼-1.42) than carers in TAU. Conclusions: Cognitive rehabilitation is feasible and potentially effective in managing the impact on everyday life of the cognitive difficulties experienced by people with dementias associated with Parkinson’s disease.
P3-006
A BUBBLING THERAPY? THE EFFECT OF CARBONATED LIQUID ON SWALLOWING DYSFUNCTION IN LEWY BODY DEMENTIAS
Victoria Larsson1, Margareta B€ulow2, Elisabet Londos3, 1Clinical Memory Research Unit, Lund University, Malm€o, Sweden; 2Diagnostic Centre of Imaging and Functional Medicine, Skane University Hospital, Lund University, Malmo, Sweden; 3Clinical Memory Research Unit, Department of Clinical Sciences, Malm€ o, Lund University, Malm€o, Sweden. Contact e-mail: [email protected] Background: Swallowing dysfunction is an increasingly recognized issue in patients with Lewy body dementia and can result in decreased quality of life, aspiration pneumonia and death. Few studies have examined dysphagia and potential therapies for Lewy body patients. Preliminary evidence suggests that carbonated liquid can improve swallowing function by increased corticobulbar excitability. The aim of this study was to examine the effect of carbonated liquid on swallowing function in Lewy body patients. Methods: Patients with a diagnosis of either dementia with Lewy bodies (n¼38) or Parkinson’s disease dementia (n¼10) were examined with a therapeutic videographic swallowing examination. Descriptive assessments of the swallowing were provided at the time of the examination by a speech and language therapist. Retrospective quantitative analysis of the videorecordings was done to compare thin, thickened and carbonated thin liquid with regards to pharyngeal transit time, pharyngeal retention and penetration. Results: Symptoms of dysphagia were present in 67% of Lewy body patients. Swallowing dysfunction was confirmed in 83% of the patients, with 85% having a pharyngeal type dysfunction. Carbonated liquid improved the swallowing in 87% of patients with a swallowing dysfunction. Carbonated liquid had a faster pharyngeal transit time compared to thin liquid (median change 150 ms, p¼0.014) and thickened liquid (median change 350 ms, p<0.0001). Conclusions:Swallowing dysfunction is common in Lewy body patients and is primarily of the pharyngeal type. Our descriptive and quantitative findings suggest that carbonated liquid improves overall swallowing function, and reduces pharyngeal transit time which when prolonged has been linked to increased aspiration risk. Larger studies are required to confirm the preliminary findings and to assess effect on quality of life, aspiration pneumonia and mortality.
P3-007
PILOT STUDY OF RTMS IN MILD TO MODERATE AD FOR 30 SESSIONS: EFFECT ON COGNITION AND GAIT PERFORMANCE AT SIX MONTHS
Vorapun Senanarong1, Sunee Bovonsunthonchai2, Nuttapol Aoonkaew1, Atthapol Raksathapat1, Suthipol Udomphanthurak1, 1Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Faculty of Physical Therapy, Mahidol University, Bangkok, Thailand. Contact e-mail: [email protected] Background: Repetitive Transcranial Magnetic Stimulation (rTMS)
can be used to modulate brain plasticity and may enhance the effects of cognitive intervention methods when administered in combination.e planned to look at efficacy of rTMS with cognitive
training on cognition and gait in persons with Alzheimer disease. Methods: We applied rTMS together with cognitive training in per-
sons with 6 mild to moderate Alzheimer disease for 1 hour daily sessions, 5 days per week, for 6 weeks (30 sessions). Three controlled subjects with mild to moderate AD received only cognitive training without magnetic stimulation (sham). All AD patients had stably been on AChEIs for 2 months. Six ROIs were targeted by the rTMS procedure concurrently with cognitive training: 1. left inferior frontal gyrus (Broca’s area); 2. left superior temporal gyrus (Wernicke’s area); 3 & 4. left and right dorsolateral prefrontal cortices (DLPFCs); and 5 & 6. left and right parietal somatosensory association cortices (R-PSAC and L-PSAC). TMSE, MOCA, Thai ADL (including basic and instrumental ADL), FAQ, NPI, VOSP test, Rey visual memory test, digit symbol, finger tapping test, BNT, color trail, and dual task gait analysis were measured preand post- stimulation at 6 months. The primary outcome was improvement of the cognitive score. The secondary outcome included improvement in Thai ADL score, Neuropsychiatric Inventory (NPI), and dual task gait performance. Results: There was a trend to improve in TMSE and MOCA at M6 from M0 in treatment arm (p¼0.05). There was a statistical significant improvement in logical memory, visual memory, BNT, and digit symbol tests in treatment arm at M6. At M6, there was an improvement in finger tapping scores between 2 arms (p¼0.047). On dual task gait performance, there was improvement in foot rotation in both feet between treatment and placebo arm at M6 (p¼0.05). No effect on NPI was found. There were no side effects during the study. Conclusions: The rTMS with cognitive training of NeuroAD System is an innovative, safe, and effective medical device for the treatment of AD.
P3-008
DIGITAL TECHNOLOGIES IN ALZHEIMER’S DISEASE CLINICAL TRIALS
Amir Kalali1, Sarah Richerson2, Arshya Vahabzadeh3, 1Quintiles, San Diego, CA, USA; 2Quintiles, Chicago, IL, USA; 3Brain Power, San Francisco, CA, USA. Contact e-mail: [email protected] Background: The landscape of clinical trials is evolving to improve
the probability of success. This includes leveraging new technologies that can impact multiple aspects of clinical trials. Methods: A review was undertaken of new technologies that could be applied to the conduct of clinical trials to improve multiple aspects of current practice. Results: Many technologies that are available have not yet been taken up by most clinical trials in Alzheimer’s disease. The potential impact of these will be presented Conclusions: It is time that technologies that are already available are leveraged to optimize the speed and the probability of success of clinical trials in Alzheimer’s disease.
P3-009
AEROBIC EXERCISE, IGF-1 AND COGNITION IN ELDERLY WITH ALZHEIMER’S DISEASE AND NONDEMENTED ELDERLY
Angelica Miki Stein1, Thays Martins Vital Silva1,2, Flavia Gomes de Melo Coelho1,3, Jessica Rodrigues Pereira1, Andre Veloso Rueda4, Jose Luiz Riani Costa1, Rosana Camarini4, Ruth Ferreira Santos-Galduroz1,5, 1UNESP Universidade Estadual Paulista, Biosciences Institute, Rio Claro, Brazil; 2 Instituto Federal Goiano, Hidrolandia, Brazil; 3Universidade Federal do
Poster Presentations: Tuesday, July 18, 2017 Triangulo Mineiro, Uberaba, Brazil; 4Universidade de S~ao Paulo, S~ao Paulo, Brazil; 5Universidade Federal do ABC, S~ao Bernardo, Brazil. Contact e-mail: [email protected] Background: IGF-1 is a putative mechanism to the effects of exer-
cise on cognition and studies have shown a resistance to IGF-1 in AD. The aim of this study was to compare the acute response to an aerobic exercise session in non-dement elderly and elderly with AD in IGF-1 levels. We also wanted to verify the chronic effects of exercise on IGF-1 levels and cognition in AD elderly. Methods: Forty non-dement elderly, [age: 74,164,61 years; Mini Mental State Examination (MMSE) median score: 28,5 points; average schooling years: 4 years]; and 34 elderly with AD, (age: 75,9 6 6,5 years; MMSE median score: 21 points; average schooling years: 4 years) were included in the study. In order to compare the IGF-1 levels after an aerobic training session, both groups did an incremental test on a treadmill. Elderly with AD were assigned to compose a Training group (TG) and a Control group (CG). The TG underwent 25-40 minutes aerobic training session on treadmill in moderate intensity, 3 times per week for 12 weeks. The CG maintained their routine. Questionnaires were applied for assessment of cognitive functions and blood samples were collected after aerobic session (non-dement elderly/ elderly with AD) and after the 12-week aerobic exercise training (TG/ CG) to measure IGF-1 levels. Results: Comparing non-dement elderly with elderly with AD, baseline IGF-1 levels showed a tendency to difference and the response for aerobic session was significantly different. The elderly with AD had lower basal IGF-1 levels than non-dement elderly (p¼0,08). Besides, the elderly with AD showed an increment in IGF-1 levels after the aerobic exercise session, while non-dement elderly had a decrease (p¼0,01). Considering the chronic effects, after 12 weeks of training, no differences between TG and CG were found in IGF-1 levels or in cognition parameters. Conclusions: non-dement elderly and elderly with AD have different response in IGF-1 levels after an acute aerobic exercise session. This response can indicate an IGF-1 resistance in AD elderly. The aerobic training did not have significantly effects on IGF-1 and cognition. The training duration (12 weeks) was not enough to improve cognition.
P3-010
LEVETIRACETAM ALTERS OSCILLATORY CONNECTIVITY IN ALZHEIMER’S DISEASE
Daniel Z. Press1,2, Christian Musaeus3, Mouhsin Shafi1, Emiliano Santarnecchi1,4, Susan T. Herman1, 1Beth Israel Deaconess Medical Center, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3Danish Dementia Research Center, Copenhagen, Denmark; 4University of Siena, Siena, Italy. Contact e-mail: [email protected] Background: Seizures occur at a higher frequency in Alzheimer’s
disease, but clinically overt events are infrequent. Subclinical epileptiform discharges may still contribute to the pathophysiology. Methods: In this pilot study (n¼7), we administered low dose levetiracetam (2.5mg/kg), higher-dose levetiracetam (7.5 mg/kg), and placebo in a double-blind, within subject, repeated measure design. We measured EEG power and EEG coherence before and after drug administration, as well as cognitive performance after drug administration. Results: We found significant increases in EEG coherence in the high beta band (24-30hz), a band where reduced coherence is seen in AD; as well as decreased coherence in the delta band (14hz), a band where there is abnormally enhanced coherence in
P933
AD. We did not see any significant cogntive changes after a single dose of drug. Conclusions: The pattern of decreased coherence in the lower frequency bands and increased coherence in the higher frequency bands suggests a beneficial effect of LEV for patients with AD. Larger longitudinal studies and studies with healthy age-matched controls are needed to determine whether longer term administration is associated with a beneficial clinical effect.
P3-011
INNOVATIVE ALZHEIMER’S DRUGS OFFER HOPE FOR ALZHEIMER’S PATIENTS AND FAMILIES: AN ANALYSIS OF THE PHASE 2 AND PHASE 3 ALZHEIMER’S DRUG PIPELINE
David Morgan, University of South Florida, Tampa, FL, USA. Contact e-mail: [email protected] Background: The purpose of the RA2 Alzheimer’s drug pipeline
report is to deliver a comprehensive look at Alzheimer’s drugs in late stage (Phase 2 and Phase 3) clinical trials and to provide a realistic estimate of when these drugs could potentially reach the market in the next five to 10 years. Methods: This analysis was constructed through extensive research and interviews, including interviews with company executives about publicly available information, SEC filings, company reports, presentations at medical conferences and media coverage. Additionally, academic research experts and select ResearchersAgainstAlzheimer’s (RA2) members provided input and review of the analysis. However, the responsibility for the content of this report belongs solely to UsAgainstAlzheimer’s, the convener of RA2, and not to any other organization or individual. When complete information pertaining to compound development milestones was not available, the research team estimated the timing of milestones based on our experience in pharmaceutical drug development. Results: RA2’s most recent pipeline analysis found that of the 23 drugs in Phase 3 clinical trials, 19 drugs could reach the market in the next five years. This information is subject to change given the nature of clinical trials and drug development, and we expect to update our pipeline analysis with the most up to date information ahead of the AAIC conference this summer. Conclusions: Given the number of Alzheimer’s drugs in clinical trials – and the diversity of approaches in development to combat the disease – there are a number of areas in which the healthcare system must improve if patients are to benefit from these new treatments, including: (1) Enhancing the training and numbers of front-line physicians, including in primary care, to diagnose and treat Alzheimer’s; (2) Improving the accuracy of diagnosis, (3) Improving communication between patients and physicians, (4) Treating Alzheimer’s like the fatal disease that it is, rather than as routine clinical care, (5) Addressing payment and reimbursement.
P3-012
OUTCOMES IN VASCULAR DEMENTIA TRIAL PATIENTS: A META-ANALYSIS OF PLACEBO DATA FROM PRIOR RANDOMIZED CONTROLLED TRIALS
Andrew Beaudin1, Alicja Cieslak2, Charlotte Zerna1, Philip Barber2, Sandra E. Black3, Richard Frayne1, Thalia S. Field4, Vladimir Hachinski5, Zahinoor Ismail2, Mukul Sharma6, Richard H. Swartz3, Eric E. Smith2,
Poster Presentations: Tuesday, July 18, 2017
status (d¼1.41) and lower levels of stress (d¼-1.42) than carers in TAU. Conclusions: Cognitive rehabilitation is feasible and potentially effective in managing the impact on everyday life of the cognitive difficulties experienced by people with dementias associated with Parkinson’s disease.
P3-006
A BUBBLING THERAPY? THE EFFECT OF CARBONATED LIQUID ON SWALLOWING DYSFUNCTION IN LEWY BODY DEMENTIAS
Victoria Larsson1, Margareta B€ulow2, Elisabet Londos3, 1Clinical Memory Research Unit, Lund University, Malm€o, Sweden; 2Diagnostic Centre of Imaging and Functional Medicine, Skane University Hospital, Lund University, Malmo, Sweden; 3Clinical Memory Research Unit, Department of Clinical Sciences, Malm€ o, Lund University, Malm€o, Sweden. Contact e-mail: [email protected] Background: Swallowing dysfunction is an increasingly recognized issue in patients with Lewy body dementia and can result in decreased quality of life, aspiration pneumonia and death. Few studies have examined dysphagia and potential therapies for Lewy body patients. Preliminary evidence suggests that carbonated liquid can improve swallowing function by increased corticobulbar excitability. The aim of this study was to examine the effect of carbonated liquid on swallowing function in Lewy body patients. Methods: Patients with a diagnosis of either dementia with Lewy bodies (n¼38) or Parkinson’s disease dementia (n¼10) were examined with a therapeutic videographic swallowing examination. Descriptive assessments of the swallowing were provided at the time of the examination by a speech and language therapist. Retrospective quantitative analysis of the videorecordings was done to compare thin, thickened and carbonated thin liquid with regards to pharyngeal transit time, pharyngeal retention and penetration. Results: Symptoms of dysphagia were present in 67% of Lewy body patients. Swallowing dysfunction was confirmed in 83% of the patients, with 85% having a pharyngeal type dysfunction. Carbonated liquid improved the swallowing in 87% of patients with a swallowing dysfunction. Carbonated liquid had a faster pharyngeal transit time compared to thin liquid (median change 150 ms, p¼0.014) and thickened liquid (median change 350 ms, p<0.0001). Conclusions:Swallowing dysfunction is common in Lewy body patients and is primarily of the pharyngeal type. Our descriptive and quantitative findings suggest that carbonated liquid improves overall swallowing function, and reduces pharyngeal transit time which when prolonged has been linked to increased aspiration risk. Larger studies are required to confirm the preliminary findings and to assess effect on quality of life, aspiration pneumonia and mortality.
P3-007
PILOT STUDY OF RTMS IN MILD TO MODERATE AD FOR 30 SESSIONS: EFFECT ON COGNITION AND GAIT PERFORMANCE AT SIX MONTHS
Vorapun Senanarong1, Sunee Bovonsunthonchai2, Nuttapol Aoonkaew1, Atthapol Raksathapat1, Suthipol Udomphanthurak1, 1Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Faculty of Physical Therapy, Mahidol University, Bangkok, Thailand. Contact e-mail: [email protected] Background: Repetitive Transcranial Magnetic Stimulation (rTMS)
can be used to modulate brain plasticity and may enhance the effects of cognitive intervention methods when administered in combination.e planned to look at efficacy of rTMS with cognitive
training on cognition and gait in persons with Alzheimer disease. Methods: We applied rTMS together with cognitive training in per-
sons with 6 mild to moderate Alzheimer disease for 1 hour daily sessions, 5 days per week, for 6 weeks (30 sessions). Three controlled subjects with mild to moderate AD received only cognitive training without magnetic stimulation (sham). All AD patients had stably been on AChEIs for 2 months. Six ROIs were targeted by the rTMS procedure concurrently with cognitive training: 1. left inferior frontal gyrus (Broca’s area); 2. left superior temporal gyrus (Wernicke’s area); 3 & 4. left and right dorsolateral prefrontal cortices (DLPFCs); and 5 & 6. left and right parietal somatosensory association cortices (R-PSAC and L-PSAC). TMSE, MOCA, Thai ADL (including basic and instrumental ADL), FAQ, NPI, VOSP test, Rey visual memory test, digit symbol, finger tapping test, BNT, color trail, and dual task gait analysis were measured preand post- stimulation at 6 months. The primary outcome was improvement of the cognitive score. The secondary outcome included improvement in Thai ADL score, Neuropsychiatric Inventory (NPI), and dual task gait performance. Results: There was a trend to improve in TMSE and MOCA at M6 from M0 in treatment arm (p¼0.05). There was a statistical significant improvement in logical memory, visual memory, BNT, and digit symbol tests in treatment arm at M6. At M6, there was an improvement in finger tapping scores between 2 arms (p¼0.047). On dual task gait performance, there was improvement in foot rotation in both feet between treatment and placebo arm at M6 (p¼0.05). No effect on NPI was found. There were no side effects during the study. Conclusions: The rTMS with cognitive training of NeuroAD System is an innovative, safe, and effective medical device for the treatment of AD.
P3-008
DIGITAL TECHNOLOGIES IN ALZHEIMER’S DISEASE CLINICAL TRIALS
Amir Kalali1, Sarah Richerson2, Arshya Vahabzadeh3, 1Quintiles, San Diego, CA, USA; 2Quintiles, Chicago, IL, USA; 3Brain Power, San Francisco, CA, USA. Contact e-mail: [email protected] Background: The landscape of clinical trials is evolving to improve
the probability of success. This includes leveraging new technologies that can impact multiple aspects of clinical trials. Methods: A review was undertaken of new technologies that could be applied to the conduct of clinical trials to improve multiple aspects of current practice. Results: Many technologies that are available have not yet been taken up by most clinical trials in Alzheimer’s disease. The potential impact of these will be presented Conclusions: It is time that technologies that are already available are leveraged to optimize the speed and the probability of success of clinical trials in Alzheimer’s disease.
P3-009
AEROBIC EXERCISE, IGF-1 AND COGNITION IN ELDERLY WITH ALZHEIMER’S DISEASE AND NONDEMENTED ELDERLY
Angelica Miki Stein1, Thays Martins Vital Silva1,2, Flavia Gomes de Melo Coelho1,3, Jessica Rodrigues Pereira1, Andre Veloso Rueda4, Jose Luiz Riani Costa1, Rosana Camarini4, Ruth Ferreira Santos-Galduroz1,5, 1UNESP Universidade Estadual Paulista, Biosciences Institute, Rio Claro, Brazil; 2 Instituto Federal Goiano, Hidrolandia, Brazil; 3Universidade Federal do
Poster Presentations: Tuesday, July 18, 2017 Triangulo Mineiro, Uberaba, Brazil; 4Universidade de S~ao Paulo, S~ao Paulo, Brazil; 5Universidade Federal do ABC, S~ao Bernardo, Brazil. Contact e-mail: [email protected] Background: IGF-1 is a putative mechanism to the effects of exer-
cise on cognition and studies have shown a resistance to IGF-1 in AD. The aim of this study was to compare the acute response to an aerobic exercise session in non-dement elderly and elderly with AD in IGF-1 levels. We also wanted to verify the chronic effects of exercise on IGF-1 levels and cognition in AD elderly. Methods: Forty non-dement elderly, [age: 74,164,61 years; Mini Mental State Examination (MMSE) median score: 28,5 points; average schooling years: 4 years]; and 34 elderly with AD, (age: 75,9 6 6,5 years; MMSE median score: 21 points; average schooling years: 4 years) were included in the study. In order to compare the IGF-1 levels after an aerobic training session, both groups did an incremental test on a treadmill. Elderly with AD were assigned to compose a Training group (TG) and a Control group (CG). The TG underwent 25-40 minutes aerobic training session on treadmill in moderate intensity, 3 times per week for 12 weeks. The CG maintained their routine. Questionnaires were applied for assessment of cognitive functions and blood samples were collected after aerobic session (non-dement elderly/ elderly with AD) and after the 12-week aerobic exercise training (TG/ CG) to measure IGF-1 levels. Results: Comparing non-dement elderly with elderly with AD, baseline IGF-1 levels showed a tendency to difference and the response for aerobic session was significantly different. The elderly with AD had lower basal IGF-1 levels than non-dement elderly (p¼0,08). Besides, the elderly with AD showed an increment in IGF-1 levels after the aerobic exercise session, while non-dement elderly had a decrease (p¼0,01). Considering the chronic effects, after 12 weeks of training, no differences between TG and CG were found in IGF-1 levels or in cognition parameters. Conclusions: non-dement elderly and elderly with AD have different response in IGF-1 levels after an acute aerobic exercise session. This response can indicate an IGF-1 resistance in AD elderly. The aerobic training did not have significantly effects on IGF-1 and cognition. The training duration (12 weeks) was not enough to improve cognition.
P3-010
LEVETIRACETAM ALTERS OSCILLATORY CONNECTIVITY IN ALZHEIMER’S DISEASE
Daniel Z. Press1,2, Christian Musaeus3, Mouhsin Shafi1, Emiliano Santarnecchi1,4, Susan T. Herman1, 1Beth Israel Deaconess Medical Center, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3Danish Dementia Research Center, Copenhagen, Denmark; 4University of Siena, Siena, Italy. Contact e-mail: [email protected] Background: Seizures occur at a higher frequency in Alzheimer’s
disease, but clinically overt events are infrequent. Subclinical epileptiform discharges may still contribute to the pathophysiology. Methods: In this pilot study (n¼7), we administered low dose levetiracetam (2.5mg/kg), higher-dose levetiracetam (7.5 mg/kg), and placebo in a double-blind, within subject, repeated measure design. We measured EEG power and EEG coherence before and after drug administration, as well as cognitive performance after drug administration. Results: We found significant increases in EEG coherence in the high beta band (24-30hz), a band where reduced coherence is seen in AD; as well as decreased coherence in the delta band (14hz), a band where there is abnormally enhanced coherence in
P933
AD. We did not see any significant cogntive changes after a single dose of drug. Conclusions: The pattern of decreased coherence in the lower frequency bands and increased coherence in the higher frequency bands suggests a beneficial effect of LEV for patients with AD. Larger longitudinal studies and studies with healthy age-matched controls are needed to determine whether longer term administration is associated with a beneficial clinical effect.
P3-011
INNOVATIVE ALZHEIMER’S DRUGS OFFER HOPE FOR ALZHEIMER’S PATIENTS AND FAMILIES: AN ANALYSIS OF THE PHASE 2 AND PHASE 3 ALZHEIMER’S DRUG PIPELINE
David Morgan, University of South Florida, Tampa, FL, USA. Contact e-mail: [email protected] Background: The purpose of the RA2 Alzheimer’s drug pipeline
report is to deliver a comprehensive look at Alzheimer’s drugs in late stage (Phase 2 and Phase 3) clinical trials and to provide a realistic estimate of when these drugs could potentially reach the market in the next five to 10 years. Methods: This analysis was constructed through extensive research and interviews, including interviews with company executives about publicly available information, SEC filings, company reports, presentations at medical conferences and media coverage. Additionally, academic research experts and select ResearchersAgainstAlzheimer’s (RA2) members provided input and review of the analysis. However, the responsibility for the content of this report belongs solely to UsAgainstAlzheimer’s, the convener of RA2, and not to any other organization or individual. When complete information pertaining to compound development milestones was not available, the research team estimated the timing of milestones based on our experience in pharmaceutical drug development. Results: RA2’s most recent pipeline analysis found that of the 23 drugs in Phase 3 clinical trials, 19 drugs could reach the market in the next five years. This information is subject to change given the nature of clinical trials and drug development, and we expect to update our pipeline analysis with the most up to date information ahead of the AAIC conference this summer. Conclusions: Given the number of Alzheimer’s drugs in clinical trials – and the diversity of approaches in development to combat the disease – there are a number of areas in which the healthcare system must improve if patients are to benefit from these new treatments, including: (1) Enhancing the training and numbers of front-line physicians, including in primary care, to diagnose and treat Alzheimer’s; (2) Improving the accuracy of diagnosis, (3) Improving communication between patients and physicians, (4) Treating Alzheimer’s like the fatal disease that it is, rather than as routine clinical care, (5) Addressing payment and reimbursement.
P3-012
OUTCOMES IN VASCULAR DEMENTIA TRIAL PATIENTS: A META-ANALYSIS OF PLACEBO DATA FROM PRIOR RANDOMIZED CONTROLLED TRIALS
Andrew Beaudin1, Alicja Cieslak2, Charlotte Zerna1, Philip Barber2, Sandra E. Black3, Richard Frayne1, Thalia S. Field4, Vladimir Hachinski5, Zahinoor Ismail2, Mukul Sharma6, Richard H. Swartz3, Eric E. Smith2,