ADCOMS sensitivity versus baseline diagnosis and progression phenotypes

Abstract BACKGROUND The Alzheimer's Disease COMposite Score (ADCOMS) is more sensitive in clinical trials than conventional measures when assessing pre‐dementia. This study compares ADCOMS trajectories using clustered progression characteristics to better understand different patterns of decline. METHODS Post‐baseline ADCOMS values were analyzed for sensitivity using mean‐to‐standard deviation ratio (MSDR), partitioned by baseline diagnosis, comparing with the original scales upon which ADCOMS is based. Because baseline diagnosis was not a particularly reliable predictor of progression, individuals were also grouped into similar ADCOMS progression trajectories using clustering methods and the MSDR compared for each progression group. RESULTS ADCOMS demonstrated increased sensitivity for clinically important progression groups. ADCOMS did not show statistically significant sensitivity or clinical relevance for the less‐severe baseline diagnoses and marginal progression groups. CONCLUSIONS This analysis complements and extends previous work validating the sensitivity of ADCOMS. The large data set permitted evaluation–in a novel approach–by the clustered progression group.