Background: Potential disease modifying therapies (DMT) for Alzheimers disease (AD) may become available in Canada although it is unclear what percentage of people presenting to specialty dementia clinics may be eligible for these treatments. We evaluated patient eligibility for potential DMTs among individuals in the PROMPT dementia research registry derived from a tertiary care cognitive clinic in Calgary, Alberta.
Methods: We analyzed all individuals included in the PROMPT registry from between July, 2010 to May, 2023 who were diagnosed with mild cognitive impairment (MCI) or possible or probable AD at their baseline assessment. The characteristics of PROMPT participants were then compared to the inclusion criteria used in recent trials of three DMTs. The proportions of individuals in the PROMPT registry who were potentially eligible for DMTs were then determined.
Results: Of the 1,900 individuals in the PROMPT registry, 1,107 were diagnosed with MCI or AD at their baseline visit (mean age 75 years and 54% male). Among this group, 54-80% met cognitive test score eligibility for different DMTs. Potential medical contraindications to treatment with DMTs were present in 29% of participants. Overall, approximately 23-34% of individuals in the PROMPT dementia registry could potentially be candidates for DMTs pending ncuroimaging and biomarker confirmation of eligibility.
Discussion: Currently -23-34% of individuals with MCI or AD referred to our tertiary care cognitive disorders could potentially be eligible for DMTs based on their initial clinic assessment. This information will help better define resource requirements for implementing AD DMTs should these become available in Canada.
Conclusions: Results from our study provide insights into the potential resources that may be needed to provide DMTs for the growing number of individuals with MCI or AD in Canada.
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1 Neurosciences Graduate Program, University of Calgary
2 Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary
3 Department of Psychiatry and Hotchkiss Brain Institute, University of Calgary
4 Department of Medicine, Cumming School of Medicine, University of Calgary.