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“Real‐world” eligibility for anti‐amyloid treatment in a tertiary memory clinic setting
Sinthujah Vigneswaran, Everard G.B. Vijverberg, Frederik Barkhof, Elsmarieke van de Giessen, Afina Willemina Lemstra, Yolande A.L. Pijnenburg, Charlotte Elisabeth Teunissen, Wiesje M. van der Flier et al.. Alzheimer s & Dementia, 2025-06-01
Topic: Amyloid, tau and blood-test diagnosis
Of 1309 new patients, 514 (39% of new patients) had clinical mild cognitive impairment (MCI) or AD. Of these, 108 (8% new patients/21% clinical MCI/AD) met Clinical Dementia Rating/MMSE criteria, were amyloid positive, and had < 4 microbleeds/superficial siderosis. After further excluding apolipoprotein E ε4/ε4 homozygotes and anticoagulant users, 79 patients (6% new patients/15% clinical MCI/AD) remained eligible. Findings indicate limited eligibility for AAT in tertiary memory clinics. HIGHLIGHTS: Initial eligibility for lecanemab was 8% of all patients and 21% of those with clinical mild cognitive impairment (MCI) or Alzheimer's disease (AD) based on approved guidelines in a tertiary memory clinic population. After strict exclusions (such as apolipoprotein E ε4/ε4 homozygosity and anticoagulant use), eligibility dropped to 6% of all patients and 15% of those with clinical MCI or AD. The study highlights the limited real-world applicability of anti-amyloid treatment under current guidelines.
Key findings
- Of 1309 new patients, 514 (39% of new patients) had clinical mild cognitive impairment (MCI) or AD.
- Of these, 108 (8% new patients/21% clinical MCI/AD) met Clinical Dementia Rating/MMSE criteria, were amyloid positive, and had < 4 microbleeds/superficial siderosis.
- After further excluding apolipoprotein E ε4/ε4 homozygotes and anticoagulant users, 79 patients (6% new patients/15% clinical MCI/AD) remained eligible.
- Findings indicate limited eligibility for AAT in tertiary memory clinics.
- HIGHLIGHTS: Initial eligibility for lecanemab was 8% of all patients and 21% of those with clinical mild cognitive impairment (MCI) or Alzheimer's disease (AD) based on approved guidelines in a tertiary memory clinic population.
Why it matters
In a tertiary memory clinic, only 8 percent of all new patients and 21 percent of those with clinical mild cognitive impairment or Alzheimer disease initially met criteria for anti-amyloid treatment. After further exclusions such as apolipoprotein E ε4/ε4 homozygosity and anticoagulant use, eligibility fell to 6 percent of all patients and 15 percent of those with clinical MCI or AD.
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Study details
- Participants1,309
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| 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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,309 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| 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 | 2 / 7 | Cited 12 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 6.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Argonde C. van Harten: h-index 24 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Vrije Universiteit Amsterdam: institution h-index 1,014 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40506692) |
| Free to read | 2 / 2 | Free to read |
| Total | 47 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Vigneswaran, S., Vijverberg, E. G., Barkhof, F., van de Giessen, E., Lemstra, A. W., Pijnenburg, Y. A., et al. (2025). “Real‐world” eligibility for anti‐amyloid treatment in a tertiary memory clinic setting. Alzheimer s & Dementia. https://doi.org/10.1002/alz.70375
Vancouver
Vigneswaran S, Vijverberg EG, Barkhof F, van de Giessen E, Lemstra AW, Pijnenburg YA, et al. “Real‐world” eligibility for anti‐amyloid treatment in a tertiary memory clinic setting. Alzheimer s & Dementia. 2025. doi:10.1002/alz.70375. PMID: 40506692.
BibTeX
@article{vigneswaran2025-40506692,
author = {Vigneswaran, Sinthujah and Vijverberg, Everard G.B. and Barkhof, Frederik and van de Giessen, Elsmarieke and Lemstra, Afina Willemina and Pijnenburg, Yolande A.L. and Teunissen, Charlotte Elisabeth and van der Flier, Wiesje M. and others},
title = {{“Real‐world” eligibility for anti‐amyloid treatment in a tertiary memory clinic setting}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.70375},
pmid = {40506692},
url = {https://doi.org/10.1002/alz.70375}
}
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