Measuring Change in Apathy Symptoms in Alzheimer’s Disease Trials
Study Overview
This study focused on participants with Alzheimer’s disease (AD) to determine the minimal clinically important difference (MCID) in apathy symptoms using three different scales.
Trial Design
The research involved analyzing changes in apathy scores from two trials: the Apathy in Dementia Methylphenidate Trial (ADMET) and ADMET 2, conducted in specialized dementia clinics across the U.S. and Canada.
Participants
A total of 260 participants were included, with 60 from ADMET and 200 from ADMET 2, all showing significant apathy related to Alzheimer’s disease.
Measurements
The study used the Clinical Global Impression of Change in Apathy scale to anchor the results. The MCID was estimated using three scales: the Neuropsychiatric Inventory — Apathy (NPI-A), Dementia Apathy Interview and Rating (DAIR), and Apathy Evaluation Scale-Informant (AES-I).
Key Findings
- MCID for NPI-A: a decrease of 4 points (95% CI: -4.0 to -4.8)
- MCID for DAIR: a decrease of 0.56 points (95% CI: -0.47 to -0.65)
- MCID for AES-I: a decrease of 3 points (95% CI: -0.9 to -5.4)
The results showed about 60% accuracy in the MCID across the three measures, with some factors like baseline apathy severity affecting these estimates.
Conclusions
The identified MCIDs for apathy will assist in evaluating treatment effectiveness on an individual basis. However, the study highlights the need to consider additional scales due to the limited correlation between MCID and clinical impressions of change.
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