Gabelle A, Guéry M, Doutriaux A, Bettayeb K
Audrey Gabelle, Biogen Digital Health, Courbevoie, France, +33 (0)6 77 23 92 69,
J Prev Alzheimers Dis. 2023;10(2):259-266. doi: 10.14283/jpad.2023.22.
Given the evolution of early diagnosis guidelines and future disease-modifying therapies, estimating the prevalence of Alzheimer's disease (AD) at early stages is key.
To estimate the number of people living with mild cognitive impairment (MCI) due to AD and mild AD dementia in France in 2022 that could be eligible to future AD therapies.
A step-by-step approach was defined based on disease stages definition and clinical practice. In line with AD guidelines, amyloid-positive profile is considered in our estimates to enhance the diagnosis accuracy of early stages of AD. Age-stratified prevalence from French cohort and international pooled analyses were identified to feed the different steps. To consider uncertainty around mean prevalence values, low and high scenarii based on the lower and upper bounds of the 95% confidence interval were conducted.
We estimated that 2.5 (low scenario: 1.7 - high scenario: 3.6) million people suffer from mild cognitive impairment in France in 2022 among whom 1.65 (low: 1.5 - high: 1.8) million people meet the criteria for mild cognitive impairment due to AD i.e., with amyloid positive profile. The expected number of clinical AD dementia is estimated at 925,886 people. Among those, 379,278 people suffer from mild AD dementia based on clinical diagnosis, including 311,043 (low: 289,174 - high: 328,332) cases with amyloid positive profile.
MCI due to AD, and mild dementia stages are potentially of high prevalence. Population-based studies are needed to confirm those estimates.
鉴于早期诊断指南的演变以及未来疾病修饰疗法的发展,估算阿尔茨海默病(AD)早期阶段的患病率至关重要。
估算2022年法国因AD导致的轻度认知障碍(MCI)和轻度AD痴呆患者中可能符合未来AD疗法条件的人数。
基于疾病阶段定义和临床实践定义了一种逐步方法。根据AD指南,在我们的估算中考虑淀粉样蛋白阳性特征以提高AD早期阶段的诊断准确性。确定了来自法国队列和国际汇总分析的年龄分层患病率,以用于不同步骤。为考虑平均患病率值周围的不确定性,基于95%置信区间的下限和上限进行了低和高两种情景分析。
我们估计2022年法国有250万(低情景:170万 - 高情景:360万)人患有轻度认知障碍,其中165万(低:150万 - 高:180万)人符合因AD导致的轻度认知障碍标准,即具有淀粉样蛋白阳性特征。临床AD痴呆的预期人数估计为925,886人。其中,基于临床诊断有379,278人患有轻度AD痴呆,包括311,043例(低:289,174例 - 高:328,332例)淀粉样蛋白阳性病例。
因AD导致的MCI和轻度痴呆阶段可能患病率较高。需要基于人群的研究来证实这些估算。