Work

Anti‐amyloid therapy eligibility in a longitudinal brain‐donor cohort with post mortem confirmation

Year: 2026

Type: article

Abstract: INTRODUCTION Anti‐amyloid therapies (AATs) for Alzheimer's disease (AD) demonstrate modest benefit in trials, but real‐world eligibility remains uncertain. Requirements including biomarker confirmation and safety exclusions may limit access. METHODS Using the Brains for Dementia Research cohort, we linked longitudinal cognitive data with post mortem neuropathology to estimate trial‐like AAT eligibility. Early stage was defined using harmonized cognitive thresholds. AD pathology required Thal amyloid phase ≥3 and Braak stage ≥IV. Exclusions were applied hierarchically: (1) vascular neuropathology, (2) anticoagulant use, and (3) apolipoprotein E ( APOE ) ε4/ε4 homozygosity. RESULTS Of 1230 participants, 945 had sufficient data; 232 had early, pathology‐confirmed AD. Vascular pathology excluded 70.7%, anticoagulant use 19.1%, and APOE ε4/ε4 homozygosity 3.6% of remaining cases. Overall, 53 individuals (4.3% of those screened) were eligible. Eligibility declined with age and was driven primarily by vascular comorbidity. DISCUSSION Using a conservative pathology‐anchored framework, only a small proportion of this older brain‐donor cohort met trial‐like eligibility criteria.

Source: Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring

DOI: 10.1002/dad2.70400

Authors: Monjurul Haque, Keeley J. Brookes, Beili Shao

Institutions: Nottingham University Hospitals NHS Trust, Nottingham Trent University, University of Nottingham

Language: English

Topic: Dementia and Cognitive Impairment Research

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,540