They would most likely recruit MCI with markers of Alzheimer's pathology - either PET, CSF (AB42/AB40 ratio or AB42/Tau quadrant) or possibly in the near future a blood test (several are in development but not as accurate). That way Anavex could enrich for people with a high likelihood of developing definite AD in a reasonable period of time. This would be a prevention study but a far cry from A273 is aspirin. Two years and 1000 patients would be plenty with this study design, keeping the study affordable.
ApoE4 testing finds those at higher risk but results gives you no indication as to when that risk may be realized (i.e. 99% of 40 year-olds who are ApoE4 will not develop AD in next 10 years even though most will by age 85). In order for treated to separate from untreated, you need the patient to have a significant chance of progressing in the next several years.
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