• Journal Article

Older Americans' Risk-benefit Preferences for Modifying the Course of Alzheimer Disease

Citation

Hauber, A., Johnson, F., Fillit, H., Mohamed, A., Leibman, C., Arrighi, H. M., ... Townsend, R. J. (2009). Older Americans' Risk-benefit Preferences for Modifying the Course of Alzheimer Disease. Alzheimer Disease and Associated Disorders, 23(1), 23-32. DOI: 10.1097/WAD.0b013e318181e4c7

Abstract

Alzheimer disease (AD) is a progressive, ultimately fatal neurodegenerative illness affecting millions of patients, families, and caregivers. Effective disease-modifying therapies for AD are desperately needed, but none currently exist on the market. Thus, accelerating the discovery, development, and approval of new disease-modifying drugs for AD is a high priority for individuals, physicians, and medical decision makers. Potentially disease-modifying drugs likely will have significant therapeutic benefits but also may have treatment-related risks. We quantified older Americans' treatment-related risk tolerance by eliciting their willingness to accept the risk of treatment-related death or permanent severe disability in exchange for modifying the course of AD. A stated-choice survey instrument was administered to 2146 American residents 60 years of age and older. On average, subjects were willing to accept a 1-year risk of treatment-related death or permanent severe disability from stroke of over 30% for a treatment that prevents AD from progressing beyond the mild stage. Thus, most people in this age cohort are willing to accept considerable risks in return for disease-modifying benefits of new AD drugs. These results are consistent with other studies indicating that individuals view AD as a serious, life threatening illness that imposes heavy burdens on both patients and caregivers