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Caregiver positivity as a psychosocial modifier of lecanemab‐related outcomes in Alzheimer's disease: A multicenter longitudinal study in China

Year: 2026

Type: article

Abstract: INTRODUCTION: Real-world modifiers of lecanemab benefit in Alzheimer's disease (AD) remain elusive. We examined associations between caregiver positivity and longitudinal outcomes in AD. METHODS: This seven-center longitudinal study followed 127 biomarker-supported AD patient-caregiver dyads over 18 months. Mixed-effects, spline, and propensity-score analyses evaluated continuous Positive Aspects of Caregiving (PAC) scores. RESULTS: Higher baseline PAC scale scores were associated with more favorable 18-month outcomes in cognition (Mini-Mental State Examination (MMSE): β = 0.42, 95% confidence interval [CI]: 0.24-0.59; p < 0.001), daily function (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]: β = 0.68, 95% CI: 0.42-0.93; p < 0.001), disease severity (Clinical Dementia Rating-Sum of Boxes [CDR-SB]: β = -0.26, 95% CI: -0.37 to -0.14; P < 0.001), patient quality of life (Quality of Life in Alzheimer's Disease [QOL-AD]: β = 0.53, 95% CI: 0.34-0.71; p < 0.001), and lower apathy (β = -0.09, 95% CI: -0.16 to -0.03; p = 0.003); these associations remained significant after multiplicity correction (all q's ≤ 0.004). Patient QOL-AD showed the most consistent sensitivity-analysis association. Apathy was associated with caregiver burden and caregiver quality of life, but mediation was not established. DISCUSSION: Caregiver positivity may stratify lecanemab efficacy in AD, supporting psychosocial assessment in personalized, caregiver-inclusive management pathways.

Source: Alzheimer s & Dementia

DOI: 10.1002/alz.71894