A recent study published in the Journal of Neurology Neurosurgery & Psychiatry found that while few individuals in the UK with early-stage Alzheimer's disease are suitable for the latest drugs aimed at halting the condition's progression, many are still likely to be referred for these treatments.

The disease-modifying drugs, lecanemab and donanemab, have shown promise in slowing cognitive decline in individuals with early-stage Alzheimer's disease. These drugs have been granted 'breakthrough therapy' status in the UK due to their ability to remove beta amyloid protein in the brain, a key factor in the disease's development.

Although these drugs are expected to receive regulatory approval for use in the UK soon, the study highlights the need for a range of clinical staff, diagnostic tests, and monitoring scans to maximize their effectiveness.

To assess the potential demand for healthcare services, researchers retrospectively evaluated patient records from community memory services in North and East London, as well as a national specialist cognitive disorders service between January and June 2022.

The study included anonymized case files of 1017 patients, with 31.5% of those seen in memory services deemed potentially eligible for treatment with the new drugs. However, the lack of fluid biomarker tests in memory clinics poses a challenge in identifying suitable patients for these treatments.

Among patients seen in specialist cognitive clinics, only 14% were potentially eligible for the new drugs after exclusions due to frailty and other factors. The study emphasizes the need for systems to manage the potential mismatch between referrals and eligibility to prevent overwhelming healthcare services.

Accurate diagnosis through confirmatory biomarker tests or brain scans is crucial to reduce the number of patients eligible for the new therapies. However, the lack of access to these tests in memory services in the UK poses a significant barrier to accurate diagnosis.

As the demand for diagnostic services is expected to increase with the approval of new drugs, healthcare services need to prepare for the additional strain on resources. The study underscores the importance of designing pathways for delivering these treatments while considering the limited eligibility of patients.

While the study has some limitations, it provides valuable insights into planning services for the potential use of new Alzheimer's treatments. Dr. Benjamin Underwood, in a related editorial, emphasizes the need to focus on providing appropriate treatment and care for the majority of individuals who may not be eligible for these new therapies.