Endpoints and outcomes: the challenge of biomarker choice for VCI trials

Clinical trials for Alzheimer’s disease (AD) have been significantly enhanced by the development of a suite of biomarkers ranging from PET and MRI modalities to CSF and now, plasma. Such biomarkers have refined trials by enabling the specific inclusion of participants with the targeted pathology. Clinical trials for vascular cognitive impairment and dementia (VCID) will require similar development and validation of biomarkers to be used for inclusion, stratification, target engagement, and efficacy in trials.