New Data Demonstrate Cognigram™ as a Sensitive Assessment to Detect and Monitor Cognitive Decline Over Time in People with a

New Data Demonstrate Cognigram™ as a Sensitive Assessment to Detect and 
Monitor Cognitive Decline Over Time in People with a Biological Marker in 
their Brain 
MONTREAL, Oct. 7, 2013 /CNW/ - Results from two new studies add to the body of 
evidence that supports Cognigram(TM) as a sensitive assessment to detect and 
monitor cognitive decline over time, namely in healthy individuals and adults 
with mild cognitive impairment (MCI) that are carriers of a biological marker 
in the brain - Aβ amyloid.(1,2)Data from two studies were presented at the 
Canadian Conference on Dementia (CCD), in Vancouver, British Columbia, between 
October 3 and 5. 
"This is a true advance in the way clinicians will be able to detect and 
monitor the progression of cognitive disorders in older people. It is the 
first time that a computerized cognitive assessment has been associated with 
levels of Aβ amyloid in the brain," says Dr. Paul Maruff, Chief Science 
Officer at Cogstate and one of the authors of the two studies."Aβ amyloid 
is a biomarker that signifies abnormal proteins in the brain and provides 
important information to indicate that the Alzheimer's disease process has 
begun. In our studies presented at CCD, we underscore the sensitivity of 
Cognigram(TM) to efficiently assess over time (up to 36 months) the decline of 
cognitive function in people whose brains had been scanned and showed presence 
of high levels of this biomarker." 
Amyloid and Cognition 
Aβ amyloid biomarkers provide important insights into the clinical course of 
cognition. Prospective studies in healthy older adults and adults with mild 
cognitive impairment have shown that high levels of Aβ amyloid are often 
associated with the decline of cognitive function and a more rapid progression 
to the next clinical disease stage.(1) 
Cognition is the mental process of knowing, including aspects such as 
awareness, perception, reasoning, and judgment. Some decrease in cognition is 
expected at older ages, but the decline is not uniform across all cognitive 
tasks or for all individuals. Impaired cognition can have health consequences, 
such as first stroke, falls, and institutionalization. It may reduce an 
individual's ability to communicate pain to health care providers, carry out 
instrumental activities of daily living, cope with chronic disease symptoms, 
perform self-care and adhere to medication instructions.( 3) 
"Dementia and Alzheimer's disease are marked by a decline in overall cognition 
and function, having a profound impact on the daily life of patients and their 
caregivers," says Dr. Louis Verret,Neurologist and Researcher, 
Interdisciplinary Memory Clinic, Centre hospitalier universitaire (CHU) de 
Québec. "As these diseases continue to escalate at an alarming rate, research 
looking at Aβ amyloid in the brain and its relationship to changes in 
cognition is an exciting area that may contribute to therapeutic interventions 
aimed at modifying the course of Alzheimer's disease-related 
neurodegeneration." 
The number of Canadians living with cognitive impairment, including dementia, 
was 747,000 in 2012 and will double to 1.4 million by 2031.(4) The annual 
economic burden is expected to increase substantially from approximately $15 
billion in 2008 to $153 billion by the year 2038.(5) 
About the Studies(1,2)
The study "Aβ amyloid and cognitive change: Decline in learning and working 
memory across the preclinical and prodromal stages of Alzheimer's disease," 
included 177 healthy older adults and 48 adults with mild cognitive impairment 
(MCI) who underwent positron emission tomography (PET) neuroimaging using 
Pittsburgh Compound B (PiB) for Aβ amyloid, APOE ɛ4 genotyping, and 
cognitive assessment using Cognigram(TM) as part of their baseline assessment 
in the Australian Imaging, Biomarkers, and Lifestyle (AIBL) study. Cognitive 
function using Cognigram™ was reassessed at 18 and 36 months later. 
"The consequences of high Aβ amyloid for performance on Cognigram(TM )in 
healthy older adults and mild cognitive impairment. Implications for early 
detection of Alzheimer's disease," study included 288 healthy older adults and 
56 adults with amnestic MCI from the AIBL study, who underwent PET 
neuroimaging using PiB for Aβ amyloid, and completed the Cognigram(TM) 
cognitive screen. 
Participants from both studies were recruited from the Australian Imaging, 
Biomarkers, and Lifestyle (AIBL) Study of Ageing, which aims to discover which 
biomarkers, cognitive characteristics, and health and lifestyle factors 
determine subsequent development of symptomatic Alzheimer's disease. The AIBL 
study is supported by the Science and Industry Endowment Fund in Australia.(6) 
Funding for the studies was provided in part by the study partners [Australian 
Commonwealth Scientific Industrial and Research Organization (CSIRO), Edith 
Cowan University (ECU), Mental Health Research Institute (MHRI), Alzheimer's 
Australia (AA), National Ageing Research Institute (NARI), Austin Health, 
Cogstate Ltd., Hollywood Private Hospital, Sir Charles Gardner Hospital]. The 
studies also received support from the National Health and Medical Research 
Council (NHMRC) and the Dementia Collaborative Research Centres program 
(DCRC2), as well as ongoing funding from the Science and Industry Endowment 
Fund (SIEF). 
About the Results(1,2)
The study "Aβ amyloid and cognitive change: Decline in learning and working 
memory across the preclinical and prodromal stages of Alzheimer's 
disease,"found that compared to healthy older adults with low Aβ amyloid, 
healthy older adults and adults with MCI with high Aβ amyloid showed a 
moderate decline across 36 months on the Cognigram(TM )learning working memory 
composite. In contrast, adults with MCI and low Aβ amyloid showed a slight 
improvement on the Cognigram(TM) learning/working memory and 
psychomotor/attention composites across the 36 months. APOE ɛ4 carriage did 
not moderate the relationship between Aβ amyloid and cognitive decline. 
"The consequences of high Aβ amyloid for performance on Cognigram(TM )in 
healthy older adults and mild cognitive impairment. Implications for early 
detection of Alzheimer's disease," study found that in healthy adults, 
performance on the attention/psychomotor function composite was equivalent 
between low and high Aβ amyloid groups.Performance on the learning/working 
memory composite was slightly worse in the high Aβ amyloid group compared to 
low Aβ amyloid group although this did not reach statistical significance. In 
MCI, performance on the attention/psychomotor function composite was 
equivalent between low and high Aβ amyloid groups however performance on the 
learning working memory composite was significantly worse in the MCI high Aβ 
amyloid group compared to the MCI low Aβ amyloid group. 
About Cognigram(TM )
Cognigram(TM) is a computer-based system designed to measure and monitor 
cognitive function for neurodegenerative diseases such as mild cognitive 
impairment and Alzheimer's disease.Merck Canada Inc. promotes Cognigram(TM) 
in Canada. Cognigram(TM) was created and is supplied by Cogstate Ltd. The 
partnership is part of the ongoing commitment from Merck to improve disease 
management involving the central nervous system. 
About Merck 
Today's Merck is a global healthcare leader working to help the world be 
well. Merck is known as MSD outside the United States and Canada. Through 
our medicines, vaccines, biologic therapies, and consumer and animal products, 
we work with customers and operate in more than 140 countries to deliver 
innovative health solutions. We also demonstrate our commitment to increasing 
access to healthcare through far-reaching policies, programs and partnerships. 
For more information about our operations in Canada, visit www.merck.ca. 
Forward-Looking Statement 
This news release includes "forward-looking statements" within the meaning of 
the safe harbor provisions of the United States Private Securities Litigation 
Reform Act of 1995. These statements are based upon the current beliefs and 
expectations of Merck's management and are subject to significant risks and 
uncertainties. There can be no guarantees with respect to pipeline products 
that the products will receive the necessary regulatory approvals or that they 
will prove to be commercially successful. If underlying assumptions prove 
inaccurate or risks or uncertainties materialize, actual results may differ 
materially from those set forth in the forward-looking statements. 
Risks and uncertainties include but are not limited to, general industry 
conditions and competition; general economic factors, including interest rate 
and currency exchange rate fluctuations; the impact of pharmaceutical industry 
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internationally; global trends toward health care cost containment; 
technological advances, new products and patents attained by competitors; 
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approval; Merck's ability to accurately predict future market conditions; 
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Merck undertakes no obligation to publicly update any forward-looking 
statement, whether as a result of new information, future events or otherwise. 
Additional factors that could cause results to differ materially from those 
described in the forward-looking statements can be found in Merck's 2012 
Annual Report on Form 10-K and the company's other filings with the Securities 
and Exchange Commission (SEC) available at the SEC's Internet site 
(www.sec.gov). 
References: 
________________________________ 
(1) Maruff, Paul et al. Aβ amyloid and cognitive change: Decline in 
learning and working memory across the preclinical and prodromal stages of 
Alzheimer's disease. Poster presented at the Canadian Conference on Dementia 
on October 4, 2013. 
(2) Maruff, Paul et al. The consequences of high Aβ amyloid for performance 
on Cognigram in healthy older adults and mild cognitive impairment. 
Implications for early detection of Alzheimer's disease. Poster presented at 
the Canadian Conference on Dementia on October 5, 2013. 
(3) Gilmour, Heather. Cognitive performance of Canadian seniors. Statistics 
Canada. June 2011. Available at: 
http://www.statcan.gc.ca/pub/82-003-x/2011002/article/11473-eng.pdf. 
(4) Alzheimer Society of Canada. A new way of looking at the impact of 
dementia in Canada. Available at: 
http://www.alzheimer.ca/~/media/Files/national/Media-releases/asc_factsheet_new
_data_09272012_en.ashx. 
(5) The Alzheimer Society. Rising Tide: The Impact of Dementia on Canadian 
Society. Executive Summary. 2010. Available at: 
http://www.alzheimer.ca/on/~/media/Files/national/Advocacy/ASC_Rising%20Tide-Ex
ecutive%20Summary_Eng.ashx. 
(6) Introducing the AIBL. The Australian Imaging, Biomarker & Lifestyle 
Flagship Study of Ageing (AIBL). May 14, 2013. Available at: 
http://www.aibl.csiro.au/. 
 

SOURCE  Merck 
Media Contacts: Sylvie Tessier Merck 514-428-3142 sylvie.tessier@merck.com 
Alexandra Fahmey Edelman 416-849-2996 alexandra.fahmey@edelman.com 
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CO: Merck
ST: Quebec
NI: MTC  
-0- Oct/07/2013 12:00 GMT