Severe Dementia

Individuals with severe dementia will not be considered for anti-amyloid therapy, but there are still other treatment options you can offer. The concern with treating severe dementia with anti-amyloid therapy is that the amount of amyloid accumulation is likely to be high. The amount of cerebral amyloid angiopathy (CAA) may also be expected to increase with overall amyloid burden. Therefore, the risk of bleeding complications with anti-amyloid therapy is thought to be higher in more severe forms of AD.

Further, it is more difficult to determine the type of dementia when individuals are severely impaired. Also, there is substantial evidence that anti-amyloid treatment does NOT REVERSE the course of cognitive or functional decline, though it may slow cognitive and functional decline. The earlier treatment can be initiated, it is thought, the more likely one may experience benefit. Thus, individuals with severe (or even advanced moderate stage) dementia are unlikely to derive benefit. Why expose someone to the expense and risks of anti-amyloid therapy if they are unlikely to benefit?

Click Exclude from Treatment if you determine that your patient has Severe Dementia.