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Background: Over the last decade, research efforts have facilitated early detection of dementia and underlying diseases, such as Alzheimer disease (AD). There is growing evidence for the benefits of early diagnosis, including access to education, available treatment and support. On the other hand, the lack of a cure and the fear to stigmatize the patient are among the arguments that speak against early disclosure of a diagnosis. General Practitioners (GPs) are often the first contact person when cognitive changes arrive, and they play a key role in early identification of the disease. Based on the experiences working with GPs as part of the multinational "Models of Patient Engagement for Alzheimer's Disease" (MOPEAD) project, an EU‐funded public‐private study within the Innovative Medicines Initiative (IMI‐2) research agenda, we aimed to assess the current attitude of GPs towards early and pre‐dementia diagnosis for AD at the stage of mild cognitive impairment (MCI) or very mild dementia. Method: We designed a survey to measure the current attitude of GPs towards early and pre‐dementia diagnosis of AD at the MOPEAD sites in five European countries (Germany, Slovenia, Spain, Sweden, and the Netherlands). The questionnaire covered several topics, including attitude towards early diagnosis, diagnostic procedures, resources and opinion on present and future treatment options. Chi‐square tests were carried out to analyze differences among countries. Result: 343 GPs completed the survey. In total, 74% of GPs indicated that they considered an early diagnosis of value. However, only 44% of GPs felt confident in handling the diagnostic procedures for very early dementia and MCI. Currently available pharmacological treatments were mostly regarded as having low benefit, while 68% considered non‐pharmacological treatment options as "beneficial and not sufficiently available". There were country‐specific differences in the GPs' perception of monetary resources (X2(4)=117.26, p <.001) and time (X2(4)=14.84, p >.01) available for the patient. Conclusion: Our findings provide an up‐to‐date overview on GPs' opinion towards early and pre‐dementia diagnosis in five European countries. We show that the majority of GPs considers an early diagnosis beneficial, yet they are faced with country‐specific challenges that can contribute to delayed or missed diagnosis. [ABSTRACT FROM AUTHOR]

Background: FDA has made great efforts to promote inclusion of women in clinical trials. The aim is to protect specific biological gender and sex issues and encourage drug developers to consider specific clinical outcomes and drug‐safety profiles in terms of gender and sex. Alzheimer's disease (AD) affects predominantly women, who double men in the number of patients diagnosed with dementia. Therefore, we explored gender and sex bias in the inclusion criteria for clinical trials in AD. Here our aim was to compare main inclusion criteria for clinical trials in MCI and dementia patients in terms of sex. Method: Patients evaluated at FACE from 1996 to 2019 with CDR 0,5 to 2 were analysed. Then, we used the main inclusion criteria for AD clinical trials to compare the sample in terms of sex and syndromic diagnosis. The chosen variables were age, sex, education, comorbidities, treatment and MMSE score. Logistic regression analysis accounting for age, years of education, MMSE, treatment and comorbidities was used. Result: From a total sample of 20,203 MCI and dementia patients, we selected potential candidates for clinical trials with complete information regarding age, age, years of education, MMSE, comorbidities and treatment. After adjusting for age, years of education, MMSE, comorbidities and treatment, in the dementia sample only age and years of education showed statistically significant differences. Whereas in the MCI sample: age, years of education, treatment and comorbidities showed statistically significant differences (Tables 1 and 2) Conclusion: Women with MCI and dementia are less likely to participate in a clinical trial due to older age and less years of education than men. Another factor that prevent women for participating in clinical trials is their comorbidities when compared to men, whereas men are excluded due to treatment criteria more often than women. These results show that there is a pre‐selection bias against women in AD clinical trials because of demographic characteristics. Therefore, participation of women in clinical trials does not reflect the prevalence of AD among women and is not representative of reality. Efforts should be made to provide equal opportunities to potential clinical trials candidates regardless of gender. [ABSTRACT FROM AUTHOR]

Background: FDA has made great efforts to promote inclusion of women in clinical trials. The aim is to protect specific biological gender and sex issues and encourage drug developers to consider specific clinical outcomes and drug‐safety profiles in terms of gender and sex. Alzheimer's disease (AD) affects predominantly women, who double men in the number of patients diagnosed with dementia. Therefore, we explored gender and sex bias in the inclusion criteria for clinical trials in AD. Here our aim was to compare main inclusion criteria for clinical trials in MCI and dementia patients in terms of sex. Method: Patients evaluated at FACE from 1996 to 2019 with CDR 0,5 to 2 evaluated from 1996 to 2019 were analyzed. Then, we used the main inclusion criteria for AD clinical trials to compare the sample in terms of sex and syndromic diagnosis. The chosen variables were age, sex, education, comorbidities, treatment and MMSE score. Logistic regression analysis was used accounting for these variables. Result: From a total sample of 20,203 MCI and dementia patients, we selected potential candidates for clinical trials with complete information regarding age, years of education, MMSE, comorbidities and treatment. After adjusting for age, years of education, comorbidities and treatment, in the dementia sample only age and years of education showed statistically significant differences. Whereas in the MCI sample: age, years of education, treatment and comorbidities showed statistically significant differences (Table 1 and 2). Conclusion: Women with MCI and dementia are less likely to participate in a clinical trial due to older age and less years of education than men. Another factor that prevent women for participating in clinical trials is their comorbidities when compared to men, whereas men are excluded due to treatment criteria more often than women. These results show that there is a pre‐selection bias against women in AD clinical trials because of demographic characteristics. Therefore, participation of women in clinical trials does not reflect the prevalence of AD among women and is not representative of reality. Efforts should be made to provide equal opportunities to potential clinical trials candidates regardless of gender. [ABSTRACT FROM AUTHOR]