Panel of Experts Calls for Comparative Effectiveness Research

Can common medical care decisions and medications help prevent dementia, or are they raising the risk of developing it? In a paper published this week in Alzheimer’s Research & Therapy, a group of experts issue a strident call for research to answer those critical questions. The authors—who include representatives from the Alzheimer’s Drug Discovery Foundation (ADDF), the American Diabetes Association, the American Heart Association, the pharmaceutical industry, and academic and government research institutes— say that, with better research, routine medical decisions could protect patients from cognitive decline and dementia. 

Lead author Penny Dacks, PhD, of the ADDF says: “We want physicians to have the information they need to protect vulnerable patients. Our hope is that these recommendations will accelerate the research needed to protect people from Alzheimer’s disease and other forms of dementia. It is exciting how quickly this evidence could have a positive impact.”

The authors make several recommendations to accelerate comparative effectiveness research. These include using complementary study designs with often-overlooked patients at high risk for cognitive decline, evaluating cognition in high-risk patients during standard medical check-ups, developing innovative tools for frequent and affordable cognitive assessment, collecting information on dementia and cognition in trials underway for other conditions, and creating incentives for healthcare providers and pharmaceutical companies to conduct comparative effectiveness research.

The paper is the result of an advisory panel on comparative effectiveness research and dementia risk convened by the ADDF in April 2015. The agenda included discussion of the existing evidence that common diseases such as diabetes, hypertension, and cardiovascular disease are risk factors for cognitive decline and dementia, which suggests that their treatments may influence that risk. The panelists also discussed treatments with potential side effects that pose risks to long-term brain health. Treatment choices could reduce such risks if clinically equivalent drugs that have protective properties for the brain are chosen, or increase them through the chronic use of drugs such as benzodiazepines and anti-cholinergic drugs that impair cognition.

Full Paper: Dacks, Penny A., Joshua J. Armstrong, Stephen K. Brannan, Aaron J. Carman, Allan M. Green, M. Sue Kirkman, Lawrence R. Krakoff, Lewis H. Kuller, Lenore J. Launer, Simon Lovestone, Elizabeth Merikle, Peter J. Neumann, Kenneth Rockwood, Diana W. Shineman, Richard G. Stefanacci, Priscilla Velentgas, Anand Viswanathan, Rachel A. Whitmer, Jeff D. Williamson, and Howard M. Fillit. "A Call for Comparative Effectiveness Research to Learn Whether Routine Clinical Care Decisions Can Protect from Dementia and Cognitive Decline." Alzheimer's Research & Therapy Alz Res Therapy 8, no. 1 (August 20, 2016). doi:10.1186/s13195-016-0200-3.