ArticleAlzheimer's & dementia (New York, N. Y.)
Measuring time saved in Alzheimer's disease: What is a meaningful slowing of progression?
Article in Alzheimer's & dementia (New York, N. Y.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Brain patterns and risk factors in the FINGER RCT multimodal lifestyle intervention.The journal of prevention of Alzheimer's disease · 2025Trial
- Clinical impact of the Alzheimer's Disease Neuroimaging Initiative: A review of studies using ADNI data (2023 to June 2025).Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Review
- The highest clinical trial failure rate for any disease in modern medicine: How both amyloid- and non-amyloid-targeting therapies failed to alter disease course in Alzheimer's disease.Free neuropathology · 2026Article
- Measuring time saved in Alzheimer's disease: What is a meaningful slowing of progression?Alzheimer's & dementia (New York, N. Y.)Article
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Authors and funding
11 authors.
Funding
Abstract
introductionMinimal clinically important differences (MCIDs) for Alzheimer's disease (AD) have previously been estimated using clinician-based anchors. However, MCIDs have been criticized for not reflecting the preferences of people living with AD (PLWAD). Furthermore, interpretations of clinical trial results have been criticized for conflating within-person meaningfulness thresholds and between-group differences. Here, we simulate scenarios of disease slowing and compare those to published MCIDs.
methodsScenarios of 5%-95% disease slowing were simulated using Alzheimer's Disease Neuroimaging Initiative (ADNI) data. Time saved and point differences on the Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) were estimated for these scenarios and compared to published MCIDs.
resultsScenario analyses resulted in estimates of time saved at ∼3 weeks-17 months and mean changes at 0.08-1.5 CDR-SB points over 18 months. The often referenced MCID for mild cognitive impairment (0.98) thereby corresponded to 11 months slowing, whereas the MCID for mild dementia (1.63) corresponded to >17 months slowing. DISCUSSION: Translating trial endpoints to estimates of time saved supports that often-referenced MCIDs may not be aligned with realistic and meaningful slowing of clinical progression. Highlights: AD slowing of clinical progression by 5%-95% resulted in 0.74-17 months saved and 0.08-1.5 CDR-SB points change at 18 months.Slowing of at least 60% or 11 months of time saved over 18 months met an often-cited MCID threshold of 0.98 points for mild cognitive impairment.For mild AD dementia, an MCID of 1.63 meant that even an 18-month delay over 18 months would be considered only borderline meaningful-a face invalid and unrealistic proposition.
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