Since most houses (certainly the one's you note as major holders of AVXL) develop and Market their own products with a Prospectus mimicking an "index" model, it seems your interpretation of these holdings as actively managed maybe erroneous. Those products are likely rebalanced in similar ways to what you seem to define as Index Funds so it is hard to consider them as anything other.
And lest some are confused, that does not even consider inflows to those products which necessarily create purchases.