Publications by authors named "Amir A Tahami Monfared"
Introduction: The availability of anti-amyloid therapy for mild cognitive impairment (MCI) due to Alzheimer's disease and mild Alzheimer's dementia (AD) has underscored the need for realistic estimates of the population with AD/MCI within the healthcare system to assure adequate preparedness. We hypothesize that administrative databases can provide real-world epidemiologic estimates reflecting the population with diagnosed (known) MCI and AD. This study was conducted to estimate diagnostic incidence and prevalence of AD and all-cause MCI among the Medicare fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries in the United States.
View Article and Find Full Text PDFMild cognitive impairment (MCI) and Alzheimer's disease (AD) have a profound impact on patients' quality of life (QoL), with progressive declines occurring as the disease advances. This systematic review aims to summarize the published evidence on patient-reported outcomes (PROs) in individuals with MCI due to AD and mild AD dementia. Comprehensive searches were conducted across five major databases to identify studies reporting on utility values, disutilities, and QoL measures in these patient populations.
View Article and Find Full Text PDFPurpose: We aimed to examine the clinical characteristics of US veterans who underwent neurocognitive test score-based assessments of Alzheimer disease (AD) stage in the Veterans Affairs Healthcare System (VAHS).
Methods: Test dates for specific stages of AD were referenced as index dates to study behavioral and psychological symptoms of dementia (BPSD) and other patient characteristics related to utilization/work-up and time to death.
Patients: We identified veterans with AD and neurocognitive evaluations using the VAHS Electronic Health Record (EHR).
Introduction: The benefits of early detection of Alzheimer's disease (AD) have become increasingly recognized. Veterans with mental health conditions (MHCs) may be less likely to receive a specific AD diagnosis compared to veterans without MHCs. We investigated whether rates of MHCs differed between veterans diagnosed with unspecified dementia (UD) vs.
View Article and Find Full Text PDFBackground: Alzheimer's disease (AD) and mild cognitive impairment (MCI) have negative quality of life (QoL) and economic impacts on patients and their caregivers and may increase along the disease continuum from MCI to mild, moderate, and severe AD.
Objective: To assess how patient and caregiver QoL, indirect and intangible costs are associated with MCI and AD severity.
Methods: An on-line survey of physician-identified patient-caregiver dyads living in the United States was conducted from June-October 2022 and included questions to both patients and their caregivers.
Background: Alzheimer's disease (AD) and related dementias are progressive neurological disorders with stage-specific clinical features and challenges. An important knowledge gap is the "window of time" within which patients transition from mild cognitive impairment or mild AD to moderate or severe AD. Better characterization/establishment of transition times would help clinicians initiating treatments, including anti-amyloid therapy.
View Article and Find Full Text PDFIntroduction: Alzheimer's disease (AD) is a disease continuum from pathophysiologic, biomarker and clinical perspectives. With the advent of advanced technologies, diagnosing and managing patients is evolving.
Methods: A systematic literature review (SLR) of practice guidelines for mild cognitive impairment (MCI) and AD dementia was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Introduction: Clinical Alzheimer's disease (AD) begins with mild cognitive impairment (MCI) and progresses to mild, moderate, or severe dementia, constituting a disease continuum that eventually leads to death. This study aimed to estimate the probabilities of transitions across those disease states.
Methods: We developed a mixed-effects multi-state Markov model to estimate the transition probabilities, adjusted for 5 baseline covariates, using the Health and Retirement Study (HRS) database.
Article Synopsis
- Alzheimer's disease (AD) progresses from mild cognitive impairment to dementia, causing significant challenges for caregivers and healthcare systems; this study evaluated the societal value of lecanemab plus standard of care (SoC) compared to SoC alone using data from Japan's CLARITY AD trial.
- A disease simulation model assessed the impact of lecanemab on disease progression, predicting patient outcomes such as life years (LYs), quality-adjusted life years (QALYs), and costs for patients and caregivers based on clinical and biomarker data.
- Results showed that lecanemab increased patient life years by 0.73 and QALYs by 0.91, with varied estimated value based on willingness-to-pay (
Article Synopsis
- The study aimed to analyze social media data from individuals involved in Alzheimer's disease (AD) to identify obstacles in the patient journey and suggest strategies for improving care.
- Researchers collected and analyzed nearly 226,000 social media posts over 23 years, categorizing the patient journey into three phases: Early Signs, Screening, and Treatment.
- Key findings indicated that anxiety was prevalent throughout all phases, with significant barriers to care access noted in the Screening and Treatment phases, particularly issues related to cost and reluctance to seek care.
Article Synopsis
- Alzheimer's disease is a leading cause of dementia and death among the elderly, with lecanemab being a new monoclonal antibody treatment that has shown promise in reducing amyloid levels and improving cognitive function in early stages of the disease.
- A recent clinical trial demonstrated that lecanemab, along with standard care, can significantly slow the progression of Alzheimer’s and extend the time before severe stages develop.
- The use of lecanemab not only enhances quality-adjusted life-years (QALYs) but also delays the need for institutional care, highlighting the importance of early intervention in Alzheimer's treatment.
The Centers for Medicare and Medicaid Services (CMS) has recently issued a national coverage determination for US Food and Drug Administration (FDA)-approved anti-amyloid monoclonal antibodies (mAbs) for the treatment of Alzheimer's disease (AD) under coverage with evidence development (CED). CED schemes are complex, costly, and challenging, and often fail to achieve intended objectives because of administrative and implementation issues. AD is a heterogeneous, progressive neurodegenerative disorder with complex care pathway that additionally presents scientific challenges related to the choice of study design and methods used in evaluating CED schemes.
View Article and Find Full Text PDFArticle Synopsis
- Alzheimer's disease (AD) is a serious condition that affects memory and cognitive function, placing a heavy burden on both caregivers and healthcare systems; this study evaluates the long-term benefits of combining lecanemab with standard care compared to standard care alone.* ! -
- A model was created to simulate lecanemab's impact on early AD using clinical data, showing that patients on lecanemab gained about 0.62 additional years of life and improved quality of life metrics over their lifespan.* ! -
- The economic analysis concluded that lecanemab, along with standard care, could be valuable from both a payer and societal perspective, with estimated costs associated with the added benefits varying between $18,709 and
Article Synopsis
- Alzheimer's disease is a complex illness with ongoing research focused on new treatments, particularly those targeting amyloid-beta, which is essential to its development.
- A study surveyed caregivers, neurologists, and payors in the U.S. to evaluate their preferences for treatment options using a multicriteria decision analysis, which broke down various decision factors and preferences.
- Results showed that all stakeholder groups prioritized drug efficacy and the benefits to patients, while cost considerations were deemed less significant in the decision-making process.
Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disease that places a substantial burden on patients, caregivers, and society. The advent of disease-modifying treatments (DMTs) would represent a major advancement in the management of AD, particularly in early AD. It is important to understand the potential value of these therapies to individuals and society.
View Article and Find Full Text PDFBackground: Social media data may be especially effective for studying diseases associated with high stigma, such as Alzheimer's disease (AD).
Objective: We primarily aimed to identify issues/challenges experienced by patients with AD using natural language processing (NLP) of social media posts.
Methods: We searched 130 public social media sources between January 1998 and December 2021 for AD stakeholder social media posts using NLP to identify issues/challenges experienced by patients with AD.
Introduction: Uncertainty surrounding the accurate assessment of the early-stage Alzheimer's disease (AD) may cause delayed care and inappropriate patient access to new AD therapies.
Methods: To analyze clinical assessments of patients with AD in the Veteran's Affairs (VA) Healthcare System and evaluate concordance between subjective and objective assessments, we processed clinical notes extracted by text integration utilities between April 1, 2008 and October 14, 2021. Veterans who had mild, moderate, or severe AD with clinical notes documenting both clinician's judgement of AD severity and objective test scores from the Mini-Mental State Examination or the Montreal Cognitive Assessment were included.
Article Synopsis
- Alzheimer's disease (AD) is a progressive condition that significantly impacts memory and behavior, creating a financial strain on caregivers and healthcare systems; this study focused on modeling the impact of lecanemab, an antibody targeting amyloid protofibrils, for early AD patients alongside standard of care (SoC).
- Using a disease simulation model based on clinical trial data, researchers evaluated how early intervention with lecanemab could affect patient outcomes, such as quality-adjusted life years (QALYs) and total care costs over a lifetime.
- The results indicated that lecanemab combined with SoC could lead to higher QALYs and lower overall costs compared to SoC alone, with potential value-based prices (VBP
Introduction: The Alzheimer's Disease Composite Score (ADCOMS) is a tool developed to detect clinical progression and measure treatment effect in patients in early stages of Alzheimer's disease (AD). The psychometric properties of the ADCOMS have been established; however, the threshold for clinical meaningfulness has yet to be identified.
Methods: Anchor-based, distribution-based, and ROC curve analyses were used to estimate clinically meaningful thresholds for change in ADCOMS for patients with mild cognitive impairment (MCI) and AD dementia.
Article Synopsis
- Alzheimer's disease (AD) is a major cause of dementia, and lecanemab is a monoclonal antibody that targets amyloid protofibrils, showing promise in early AD treatment by reducing brain amyloid and slowing cognitive decline in a clinical trial.
- A disease simulation model was developed to project long-term outcomes of lecanemab, comparing its effects when added to standard care versus standard care alone for patients with mild cognitive impairment and mild AD dementia.
- Results indicate that lecanemab treatment could extend the duration of early-stage AD and delay progression to more severe stages, leading to increased life years, improved quality of life for patients and caregivers, and a lower likelihood of needing institutional care.
Alzheimer's disease (AD) is prevalent throughout the world and is the leading cause of dementia in older individuals (aged ≥ 65 years). To gain a deeper understanding of the recent literature on the epidemiology of AD and its progression, we conducted a review of the PubMed-indexed literature (2014-2021) in North America, Europe, and Asia. The worldwide toll of AD is evidenced by rising prevalence, incidence, and mortality due to AD-estimates which are low because of underdiagnosis of AD.
View Article and Find Full Text PDFAlzheimer's disease (AD) is the leading cause of cognitive impairment and dementia in older individuals (aged ≥ 65 years) throughout the world. As a result of these progressive deficits in cognitive, emotional, and physical function, AD dementia can cause functional disability and loss of independence. To gain a deeper understanding of the recent literature on the burden of AD, including that of mild cognitive impairment (MCI) due to AD, we conducted a comprehensive targeted review of the PubMed-indexed literature (2014 to 2021) to examine the humanistic and economic burden of AD (including MCI) in North America, Europe, and Asia.
View Article and Find Full Text PDFIntroduction: The Alzheimer's disease (AD) composite score (ADCOMS) has been shown to be a more sensitive measure of cognitive change in early AD (i.e., mild cognitive impairment [MCI] and mild AD) than commonly used measures.
View Article and Find Full Text PDFStudy Objectives: This systematic literature review and meta-analysis explored the impact of lemborexant and other insomnia treatments on next-day driving performance.
Methods: Searches were conducted in MEDLINE and Embase on May 16, 2019, supplemented by clinical trial registries. Randomized controlled trials in healthy volunteers or people with insomnia were included if they reported a standardized on-road driving test, were published in English and included ≥1 group receiving a recommended dose of flunitrazepam, estazolam, triazolam, temazepam, brotizolam, etizolam, alprazolam, lorazepam, zolpidem, eszopiclone, zaleplon, zopiclone, trazodone, ramelteon, lemborexant, or suvorexant.