title: Function and clinical meaningfulness of treatments for mild Alzheimer's disease.
abstract: BACKGROUND
  Effectiveness of Alzheimer's disease (AD) treatments is commonly evaluated with coprimary outcomes; cognition with function to ensure clinical meaningfulness of a cognitive effect.
  
  
  METHODS
  We reviewed the literature for functional outcomes in mild AD or mild cognitive impairment (MCI) patients (distinct from combined mild-moderate/severe AD) treated with approved AD drugs. Cognitive and functional treatment differences in mild AD patients in solanezumab EXPEDITION/EXPEDITION2 studies were compared across time.
  
  
  RESULTS
  Seven publications provided MCI/mild AD functional outcomes, one of which reported a significant functional treatment effect. Secondary analyses of EXPEDITION studies suggested a smaller functional effect of solanezumab relative to cognition. An increasing effect of solanezumab over 18 months was shown for cognition and function.
  
  
  CONCLUSIONS
  Function as the sole measure to demonstrate clinical meaningfulness of cognitive effects in mild AD may have limitations. For disease-modifying treatments, point differences on cognitive and functional scales should be qualified with duration of treatment.
authors.affiliation: Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Siemers
authors.affiliation: Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Karen Chilcott
authors.initials: KC
authors.lastname: Holdridge
authors.affiliation: Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Sundell
authors.affiliation: Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu-Seifert
keywords: Alzheimer's disease; Clinical meaningfulness; Clinical relevance; Cognitive rating scales; Functional rating scales; Global rating scales; Mild cognitive impairment; Solanezumab