What is new in research on dementia?
In this Research Roundup, we explore new studies on dementia, focusing on a treatment for agitation in Alzheimer dementia, effects of menopause hormone therapy on risk of Alzheimer disease and dementia, and differences between sporadic early onset and dominantly inherited Alzheimer disease.
A Look at Sporadic Early Onset vs Dominantly Inherited Alzheimer Disease
In this study, investigators explored the cognitive, clinical, and biomarker profiles of early-onset Alzheimer disease (AD) with a focus on similarities and differences between dominantly inherited and sporadic cases. They identified differences in the baseline profiles between inherited and sporadic AD, including that sporadic early-onset AD features a higher frequency of atypical clinical presentations, later age of onset, and worse executive performance at baseline in comparison to inherited AD.
“These findings indicate that despite having different causes, familial and [sporadic early-onset Alzheimer disease] (sEOAD) share many aspects of pathophysiology (eg, biomarkers levels) and clinical progression,” the investigators concluded. “Differences in presenting clinical profiles suggest that clinical outcome measures tailored to each population may be needed in clinical trials specific to [dominantly inherited Alzheimer disease] (DIAD) and sEOAD.”
Llibre-Guerra JJ, Iaccarino L, Coble D, et al. Longitudinal clinical, cognitive and biomarker profiles in dominantly inherited versus sporadic early-onset Alzheimer's disease. Brain Commun. 2023;5(6):fcad280.
Efficacy, Safety, and Tolerability of Brexpiprazole for Agitation in Alzheimer Dementia
This randomized clinical trial explored the safety, tolerability, and efficacy of brexpiprazole for the treatment of agitation in patients with Alzheimer dementia. The investigators determined that brexpiprazole was largely well tolerated over 12 weeks, with the participants with Alzheimer dementia who took 2 mg or 3 mg brexpiprazole showing statistically significant improvement in agitation in comparison with those who took placebo.
“Overall, brexpiprazole, 2 or 3 mg, appears to have a favorable benefit/risk profile in the treatment of agitation in Alzheimer dementia,” the investigators concluded. “Based on the results of this trial, together with a previous trial, brexpiprazole was approved in the United States for the treatment of agitation associated with dementia due to Alzheimer disease.”
Lee D, Slomkowski M, Hefting N, et al. Brexpiprazole for the treatment of agitation in Alzheimer dementia: a randomized clinical trial [published online ahead of print, 2023 Nov 6]. JAMA Neurol. 2023;e233810.
Effects of Menopause Hormone Therapy on Risk of Dementia, Alzheimer Disease
This systematic review and meta-analysis analyzed the effects of menopausal hormone therapy (HT) on risks of Alzheimer disease (AD) and dementia. The investigators found that, when initiated during the window of the transition to menopause, estrogen therapy may reduce the risk of AD and support neurological function in some patients.
“We recognize and emphasize the inherent limitations of relying largely on observational data and that stronger, randomized controlled trial evidence is needed to fortify these conclusions,” the investigators wrote. “Overall, these findings provide new insights on the association between HT use and AD incidence, and support renewed research interest in evaluating HT for the purpose of AD and dementia risk reduction.”
Nerattini M, Jett S, Andy C, et al. Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia. Front Aging Neurosci. 2023;15:1260427.
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