Matthias W Riepe

Title : Memory should be the primary endpoint in early AD

Abstract:

Choosing the endpoint of analysis of treatment efficacy determines the size of treatment effect. Effect size calculation of composite endpoints cannot be used for analysing treatment efficacy as it is distorted by the interaction of instrument and severity of disease Decline of cognitive function in Alzheimer’s disease (AD) follows a characteristic and sequential pattern. At onset, deficits of episodic memory and spatial orientation are predominant. With spread of the disease, the severity of these symptoms increases, and further impairments accrue. This deterioration comprises executive functions, attention, working memory, visuospatial functions, and further domains. An itemized analysis of the Mini-Mental Status Examination (MMSE) demonstrates that decline in memory items precedes every other cognitive function. We conclude that memory performance is the single most important measure of decline at onset of clinical manifestation of AD. Thus, memory performance rather than any score of any additive scale should be the primary endpoint in clinical trials in patients with mild cognitive impairment / early AD. Use of composite scales underestimates treatment efficacy in mild cognitive impairment and incipient AD.

Biography:

After graduating (Medicine, Physics) in Münster, Germany, Matthias worked at the Charité in Berlin, Germany, the Center for Research on Occupational and Environmental Toxicology in Portland, Oregon, USA, the Wadsworth Center for Laboratories and Research in Albany, New York, USA, and again at Charité Medical Faculty in Berlin. He was appointed full professor in 2004 at the Charité. Since 2008 he is Full Professor of Mental Health & Old Age Psychiatry, Ulm University and Head of the Department of Geriatrics and Old Age Psychiatry at Bezirkskrankenhaus Günzburg. Professor Riepe is board certified in Neurology, Psychiatry and Psychotherapy, and Geriatrics.