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The Challenge of Detecting Prodromal Alzheimer’s Disease for Clinical Trials

Alzheimer’s disease (AD) trials require participants with a specific biomarker and cognitive profile, targeting particular disease severity (e.g. prodromal vs. MCI vs. AD).

Finding participants for clinical trials in the pre-clinical or prodromal stage of Alzheimer’s disease prior to the onset of cognitive and functional decline can be challenging, time-consuming and expensive. Episodic memory tasks such as CANTAB Paired Associates Learning (PAL) are associated with AD biomarkers, hippocampal and temporal-frontal network function and may therefore be useful for pre-screening.

This study, the results of which were presented at ADPD 20017, aimed to assess the utility of CANTAB PAL to i) enrich samples for amyloid-positive participants and; ii) identify deficits in other commonly-used cognitive tasks such as CERAD learning and delayed recall.


Data were evaluated from EDAR, a Europe-wide prospective longitudinal study assessing the potential of biomarkers including cognitive assessments in the early diagnosis of Alzheimer’s disease.

The ability of PAL to detect a deficit in the CERAD was based on logistic regression adjusted for age and gender. A one standard deviation deficit on the CERAD list-learning task was calculated using age-adjusted standardised norms.


Pre-screening of episodic memory can enrich samples for Aβ+ subjects, and identify those likely to show deficits in other cognitive tasks. The CANTAB web-based platform provides a validated and highly-sensitive cognitive assessment for pre-screening that can be administered on a home computer and can help reduce the rate of in-clinic screen failures.

Interested in learning more about enriching patient recruitment through the identification of episodic memory deficits at pre-screening? Download this poster.


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