Washington University School of Medicine researchers have developed a groundbreaking way to communicate the real-world impact of new Alzheimer's treatments, translating complex clinical trial data into meaningful outcomes for patients and their families.
The analysis, published in Alzheimer's & Dementia: Translational Research & Clinical Interventions on February 13, 2025, focuses on the FDA-approved antibody therapies lecanemab and donanemab, which target amyloid proteins in the brain.
Practical Benefits for Patients
For patients with very mild Alzheimer's symptoms, the study revealed significant gains in independent living:
- Lecanemab treatment: Additional 10 months of independence
- Donanemab treatment: Additional 8 months of independence
- Without treatment: Expected 29 months of independent living
"What people want to know is how long they will be able to live independently, not something abstract like the percent change in decline," explains Dr. Sarah Hartz, senior author and professor of psychiatry at WashU Medicine.
Impact on Different Disease Stages
The research team analyzed data from 282 participants at WashU Medicine's Charles F. and Joanne Knight Alzheimer Disease Research Center. For patients with mild symptoms who were already experiencing some dependency, the findings showed:
- Lecanemab: 26 additional months of self-care independence
- Donanemab: 19 additional months of self-care independence
Treatment Considerations and Challenges
The new treatments present complex decisions for patients and families. While offering meaningful benefits, these therapies:
- Do not reverse or halt disease progression
- Require regular infusions (biweekly or monthly)
- Carry risks of brain bleeds and swelling
- Involve significant treatment costs
Dr. Suzanne Schindler, associate professor of neurology at WashU Medicine, emphasizes the personal nature of treatment decisions: "The question of whether these drugs would be helpful for any particular person is complicated and has to do with not only medical factors but the patient's priorities, preferences, and risk tolerance."
Measuring Independence
The researchers identified two critical transition points in disease progression:
- Loss of ability to manage daily tasks (meal preparation, driving, financial management)
- Loss of basic self-care capabilities (bathing, dressing, toileting)
This framework provides patients and families with concrete metrics to evaluate treatment options. "The purpose of this study is not to advocate for or against these medications," notes Dr. Hartz. "The purpose is to put the impact of these medications into context in ways that can help people make the decisions that are best for themselves and their family members."
