Introduction: Alzheimer's disease (AD) trials require enrollment with an informant.

Methods: We assessed relationships between informant replacement and Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) scores across four AD trials. Using generalized estimating equations, we examined associations between replacement and change in ADCS-ADL between successive visits. We used analysis of covariance to estimate the association between replacement and 18-month change from baseline, and an test to compare the variance of this change.

Results: Among 1336 participants, 63 (≈5%) experienced replacement. Between-visit mean change in ADCS-ADL was 2.44 points lower comparing replacement to stable informants (95% confidence interval [CI]: -3.91, -0.98). The difference in between-visit mean absolute change was 2.38 points (95% CI: 1.24, 3.52). Replacement was not significantly associated with an 18-month change from baseline. The ratio of variances (replacement/stable) was 1.80 (95% CI: 1.19, 2.99).

Discussion: Informant replacement is associated with bias and increased variability between visits and increased variance for overall ADCS-ADL.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716564PMC
http://dx.doi.org/10.1002/trc2.12439DOI Listing

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