Synergy in Action

Behavioral and psychological symptoms in dementia (BPSD): A way forward?

Chairs: Larry Ereshefsky; Luca Pani

The constellation of symptoms/syndromes comprising BPSD (NPS) present a challenge at all levels of health care, from unmet patient and caregiver needs, to drug discovery, to clinical trials, as well as to regulatory pathways. A review of the ‘lessons learned’ from recent efforts to develop drug treatments for Agitation or Psychosis in neurodegenerative disorders will be applied to enable methodological discussions on the development of treatments for Apathy in Alzheimer’s Disease (AD). We will explore how Apathy symptoms and potential biomarkers ‘evolve’ across the spectrum from Mild Brain Impairment (MBI) to Mild Cognitive Impairment (MCI) to AD. What are accepted diagnostic criteria for Apathy in AD and will disease progression affect treatment targets and assessment tools? How should pseudo-specificity be addressed in identifying and assessing apathy? Differentiation from depression and relationship with changes in cognition will be discussed. What are the challenges of conducting translational and proof of concept work in patients with Apathy in MBI/MCI? The application of neurocircuitry strategies and other biomarker approaches in early drug development could de-risk POC.  Regulatory considerations of approaches and methodologies to improve the likelihood of meaningful signal detection and acceptable registration trials will be discussed.