Samuel Dickson, 2261 East 3300 South, Millcreek, UT 84109, Cell: 240-397-5211, Email:
J Prev Alzheimers Dis. 2024;11(4):992-997. doi: 10.14283/jpad.2024.55.
Assessment of meaningfulness in randomized clinical trials (RCTs) in Alzheimer's disease (AD) is challenging, particularly in early disease. Converting clinical outcomes to disease progression time allows assessment of treatment effects using a metric that is understandable and meaningful: time. We demonstrate time savings assessments using meta time component tests (TCTs) in the LipiDiDiet multinutrient RCT. Dietary patterns are important for dementia prevention, likely due to individual cumulative nutrient effects. LipiDiDiet used a multinutrient (Fortasyn Connect) formulation in patients with prodromal AD, benefitting cognition (5-item composite NTB, effect 0.089), cognition and function (CDR-SB, -0.605), and slowing hippocampal atrophy (0.122 cm3). Meaningfulness of point differences is unclear. However, a combination TCT showed 9-month disease time savings at 24 months (38% slowing of disease time): 9.0, 10.5, and 7.2 months for NTB, CDR-SB, and hippocampal volume, underscoring the value of TCTs in AD RCTs and the need for continued validation of this approach.
评估阿尔茨海默病(AD)随机临床试验(RCT)的意义具有挑战性,特别是在疾病早期。将临床结果转化为疾病进展时间,可以使用可理解且有意义的指标评估治疗效果:时间。我们在 LipiDiDiet 多营养 RCT 中使用荟萃时间成分测试(TCT)来评估时间节省。饮食模式对预防痴呆很重要,这可能是由于个体累积营养效应。LipiDiDiet 在前驱 AD 患者中使用了多种营养(Fortasyn Connect)配方,有益于认知(5 项综合 NTB,效果 0.089)、认知和功能(CDR-SB,-0.605)以及减缓海马萎缩(0.122cm3)。点差异的意义尚不清楚。然而,组合 TCT 显示 24 个月时 9 个月的疾病时间节省(疾病时间减缓 38%):NTB、CDR-SB 和海马体积分别为 9.0、10.5 和 7.2 个月,突出了 TCT 在 AD RCT 中的价值,以及需要继续验证这种方法。