Therapeutic Landscape of Early Symptomatic Alzheimer’s Disease Translated into Everyday Practice for Geriatric Providers

Melissa J Bailey-Taylor,1 Paula Morrow,1 James Hendrix,1 Katherine E Galluzzi,2 Golnosh Sharafsaleh3 1Eli Lilly and Company, Indianapolis, IN, USA; 2Department of Geriatrics, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA; 3Golden Oak Medicine PLLC, Asheville, NC, USACorrespondence: Paula Morrow, Eli Lilly and Company, Indianapolis, IN, 46285, USA, Tel +1 317 439 6042, Email [email protected]: Alzheimer’s disease (AD) accounts for 60– 80% of all dementia cases. Recent advances in diagnostic biomarkers of early symptomatic AD (ie, mild cognitive impairment and mild dementia due to AD) and amyloid-targeting therapies (ATTs) have the potential to improve outcomes for patients with AD. Two ATTs (donanemab and lecanemab) are currently approved and available for use in the US. Both ATTs can slow disease progression as well as cognitive and functional decline in patients with early symptomatic AD. Treatment with ATTs is associated with specific safety concerns such as amyloid-related imaging abnormalities. Therefore, the benefit versus risk profile needs to be carefully considered when deciding whether to treat a patient with ATTs. This review aims to educate geriatric-trained health professionals regarding advances in the diagnosis and treatment of early symptomatic AD, including the optimal duration of treatment, management of adverse reactions, and patient counseling. It also discusses key considerations in care transitions and patient management in multidisciplinary settings to ensure continuous patient-centered care.Keywords: amyloid-targeting therapies, biomarkers, early symptomatic Alzheimer’s disease, mild cognitive impairment, mild dementia