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Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment
Reynolds EL, Elafros MA, Muthukumar L, Shippey E, Budhu JA, Terman SW, Burke JF, Callaghan BC.. Neurology, 2026-10-15
Topic: Amyloid, tau and blood-test diagnosis
We determined the demographics and social drivers of health associated with utilization and initial adherence of these medications. Results We identified 1,198,362 participants with MCI/dementia, of whom 2,427 (0.2%) were prescribed an antiamyloid medication. We found that higher age (odds ratio [OR] 0.93, 95% CI 0.92-0.94), higher Elixhauser comorbidity index (OR 0.56, 95% CI 0.52-0.59), being non-Hispanic Black (OR 0.14, 95% CI 0.09-0.23), and being Hispanic (OR 0.21, 95% CI 0.13-0.36) associated with lower odds of receiving an antiamyloid medication. Furthermore, having greater VVI was associated with lower odds of receiving an antiamyloid medication. By contrast, only higher Elixhauser comorbidity score was associated with lower initial medication adherence (rate ratio 0.94, 95% CI 0.93-0.96), but not age, sex, race/ethnicity, and overall vulnerability. Discussion We found that younger, non-Hispanic White patients, with fewer comorbidities, and lower vulnerability, were more likely to receive antiamyloid medications. By contrast, among patients receiving an antiamyloid medication, only higher comorbidity score associated with lower initial medication adherence. These findings indicate a potential disparity in medication access for US patients with MCI/dementia that could become problematic barriers to care as medications for dementia continue to evolve.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Reynolds, E. L., Elafros, M. A., Muthukumar, L., Shippey, E., Budhu, J. A., Terman, S. W., et al. (2026). Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment. Neurology. https://doi.org/10.1212/wnl.0000000000218594
Vancouver
Reynolds EL, Elafros MA, Muthukumar L, Shippey E, Budhu JA, Terman SW, et al. Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment. Neurology. 2026. doi:10.1212/wnl.0000000000218594. PMID: 42879726.
BibTeX
@article{reynolds2026-42879726,
author = {Reynolds, E. L. and Elafros, M. A. and Muthukumar, L. and Shippey, E. and Budhu, J. A. and Terman, S. W. and Burke, J. F. and Callaghan, B. C.},
title = {{Predictors of Antiamyloid Medication Utilization and Adherence Among People With Alzheimer Disease and Mild Cognitive Impairment}},
journal = {Neurology},
year = {2026},
doi = {10.1212/wnl.0000000000218594},
pmid = {42879726},
url = {https://doi.org/10.1212/wnl.0000000000218594}
}
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Key findings
- We determined the demographics and social drivers of health associated with utilization and initial adherence of these medications.
- Results We identified 1,198,362 participants with MCI/dementia, of whom 2,427 (0.2%) were prescribed an antiamyloid medication.
- We found that higher age (odds ratio [OR] 0.93, 95% CI 0.92-0.94), higher Elixhauser comorbidity index (OR 0.56, 95% CI 0.52-0.59), being non-Hispanic Black (OR 0.14, 95% CI 0.09-0.23), and being Hispanic (OR 0.21, 95% CI 0.13-0.36) associated with lower odds of receiving an antiamyloid medication.
- Furthermore, having greater VVI was associated with lower odds of receiving an antiamyloid medication.
- By contrast, only higher Elixhauser comorbidity score was associated with lower initial medication adherence (rate ratio 0.94, 95% CI 0.93-0.96), but not age, sex, race/ethnicity, and overall vulnerability.
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Study details
- Participants1,198,362
- Effect size0.2%; 69.9%; 56.1%
- Evidence strengthLow
How this study scored 62/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 36 of the 58 points we could judge it on, which is 62 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 4 / 4 | 1,198,362 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42879726) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 36 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 36 of the 58 points we could judge it on is 62 out of 100. |
| Total | 62 / 100 | — |
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