COIOS
Healthcare today Item new peer-reviewed

Most dementia trial participants had mixed brain pathology, not the one targeted

Among 67 autopsied participants in Alzheimer's and related dementia trials at a Kentucky research centre, only 10–29% had solely the pathology the intervention was designed to target, with a mean of 2.54 pathological features per person.

Researchers linked autopsy findings from a community-based Kentucky cohort (614 autopsies, deaths 2005–2024) to records of participation in dementia interventional trials, identifying 67 participants across prevention, mild cognitive impairment/early dementia, and vascular cognitive impairment trials. Pure on-target pathology was found in 29%, 23% and 10% of those groups respectively, and participants carried a mean of 2.54 pathological features each. Trial participants differed from the trial-naive only in slightly higher education.

Why it is interesting: It quantifies how far the brains in single-mechanism dementia trials depart from the single mechanism, bearing on how anti-amyloid and related trial results should be read.

Source
The journal of prevention of Alzheimer's disease, 2026-09-15
DOI
10.1016/j.tjpad.2026.100669
Type
Peer-reviewed article
Design
Retrospective autopsy series, 614 autopsied community cohort members, 67 former dementia trial participants, deaths 2005–2024, University of Kentucky ADRC
Verdict
New finding
Driver
Dementia