Abstract Details

Title Is Rural America Ready for Anti-amyloid Therapy?

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P1 - Poster Session 1 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-019

Objective To assess the proportion of patients referred to a rural neurology clinic who might be candidates for Lecanemab based on clinical diagnosis and dementia severity

Background Lecanemab, an amyloid-beta-targeting antibody, shows promise for early-stage Alzheimer's. Identifying eligible patients, especially with mild cognitive impairment, is key. In rural areas, diagnoses are delayed, and biomarker access is limited. The average dementia diagnosis age is 80-82, mostly female, with an initial MMSE score of 24-26

Design/Methods This study retrospectively analyzed memory loss or dementia referrals, considering demographics (age, gender), cognitive scores (MOCA, MMSE), and diagnoses (subjective memory impairment, MCI, suspected Alzheimer's, or other dementia). Potential Lecanemab candidates were those diagnosed with MCI or suspected Alzheimer's with an MMSE score of 22+ or a MOCA score of 15+ (MOCA being the clinic's default screening tool).

Results

Of 61 referrals, 37 patients (61%) were potential candidates for Lecanemab, mostly with early-stage Alzheimer’s dementia. Of these, 59% were female and 41% male. The average age was 72.3 years, with 70.4 for MCI patients and 78.7 for suspected Alzheimer’s patients. The average MOCA score for patients over age 50 was 18.9, with 22.1 for MCI patients and 13.4 for suspected Alzheimer’s patients. Five patients screened with MMSE averaged 16.4. Twelve were on donepezil, 5 on memantine, and 24 had psychiatric comorbidities.

Conclusions A significant portion of clinic referrals could benefit from amyloid-targeting therapies like Lecanemab. The average age of referrals was lower than typical dementia onset, though cognitive test scores aligned with national averages, likely due to selective referrals or earlier onset in the region. The study lacks data on patients not referred for neurological assessment. Early Alzheimer's identification and triage are crucial, especially with limited access to biomarker-based diagnoses in rural areas. This may improve with serum amyloid testing, and future research should account for regional demographic variations

Authors/Disclosures
Jamil Numan, MD (Marshall University/ MUSOM) PRESENTER	Dr. Numan has nothing to disclose.
Micaela R. Owens, DO (Marshall University)	Dr. Owens has nothing to disclose.

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