Older Adults, Anti-Amyloid Therapy, and Frailty: What Oncology Can Teach Us - PubMed
6 hours ago
- #Alzheimer's disease
- #frailty assessment
- #geriatric oncology
- Anti-amyloid therapies like lecanemab and donanemab are approved for early Alzheimer's disease with confirmed amyloid pathology, but their use in older adults is complicated by varying functional reserve and multimorbidity.
- A conceptual framework from geriatric oncology, utilizing frailty assessment and comprehensive geriatric assessment (CGA), is proposed to individualize treatment decisions for anti-amyloid therapies.
- The framework involves a stepwise process that combines regulatory eligibility with brief frailty screening and targeted CGA, creating distinct pathways for robust, pre-frail, and frail individuals.
- Frailty status guides decisions on treatment initiation, prehabilitation, monitoring intensity, and possible treatment deferral, aiming to assess physiological reserve, treatment burden, and monitoring feasibility.
- This frailty-informed approach supports ethical and practical real-world implementation of anti-amyloid therapies, aiding in treatment selection and longitudinal management decisions.