Antiamyloid Monoclonal Antibodies in Alzheimer's Disease Part 2: Challenges in Dementia Care Delivery System Logistics

J Neuropsychiatry Clin Neurosci. 2025 Jun 26:appineuropsych20240203. doi: 10.1176/appi.neuropsych.20240203. Online ahead of print.

Abstract

Alzheimer's disease (AD) is a common neurodegenerative illness affecting nearly 7 million people in the United States. Until 2023, no disease-targeting pharmacotherapeutics were widely available outside of research studies. With relatively recent regulatory approval and increasing availability of antiamyloid therapies (AATs) in the United States, management of AD is rapidly shifting from symptomatic and supportive care alone to treatments aimed at disease modification. Appropriate selection of patients for AATs can be challenging and varies among health care settings and systems despite published appropriate-use recommendations. The first of this two-part Treatment in Behavioral Neurology & Neuropsychiatry series from the American Neuropsychiatric Association Dementia Special Interest Group addresses the challenges with patient selection. In this second part, the authors offer dementia-focused health care vignettes to illustrate challenges with AAT delivery encountered in different settings and discuss emerging logistical issues associated with delivery of dementia-focused care based on AAT protocols.

Keywords: Alzheimer’s disease; Anti-amyloid therapy; Biomarkers; Dementia; Mild cognitive impairment; New drug development.