Inside Scoop on Alzheimer’s Disease

Diagnosis

Diagnosis is made by careful clinical history from both patient and family, neurological examination, formal cognitive testing and laboratory testing, which usually includes testing vitamin levels, endocrine function and biomarkers.

Biomarkers

Plasma Phosphorylated Tau 217 and Aβ42/40 are very specialized laboratory tests that are very helpful in the diagnosis of Alzheimer’s disesae

https://jamanetwork.com/journals/jamaneurology/fullarticle/2821934

Treatment

Treatment basically is centered around healthy living, diet, checking hearing and vision, exercise and medications

  1. Check sight and hearing)
  2. Keep on learning, use your brain
  3. Surround yourself with family and friends
  4. Be conscientious, not neurotic. Keep stress down.
  5. Make sleep your priority
  6. Exercise and eat healthy

Medications

Anticholinesterase Inhibitors

Common drugs in this class include donepezil and galantamine. These drugs are safe and appear beneficial in at least 50% of patients. Dr Varipapa suggests a 3-4 month trial and then assess benefit. Side effects are not common, and usually limited to nausea, vomiting and diarrhea. These medication can be obtained for less than $10 per month.

https://costplusdrugs.com/medications/donepezil-10mg-tablet/

NMDAR Inhibitor

Memantine is a second-line medication. It can be used alone or with donepezil and other medications. Side effects are rare and cost is less that $10 per month.

https://costplusdrugs.com/medications/memantine-10mg-tablet/

Amyloid-clearing drugs

The FDA recently granted approval for Lecanemab (Leqembi) and Donanemab (Kisunla)
Here are the basic facts you should know about these medications
1. Indicated only for patients with early Alzheimers with elevated beta-amyloid
2. It is not curative; it appears to modestly slow disease progression.
3. It will not restore cognitive disfunction.
4. A PET scan, biomarker blood test or LP is required before starting.
5. The medication is given by IV infusion.
5. The cost is around $25,000 to $30,000 per year just for the medication.
6. There will be additional costs for the infusion and follow up brain scans.
7. Side effects include brain swelling and bleeding.

Important Update on Donanemab (Kisunla)
https://cnmri.com/2025/07/14/fda-approves-label-change-for-alzheimers-drug/

Detailed Article on Lecanemab Controversy

lecanemab-controversy-1Download

Implications of the Approval of Lecanemab for Alzheimer Disease Patient Care
https://n.neurology.org/content/neurology/101/14/610.full.pdf

implications-of-the-approval-of-lecanemab-for-alzheimer-disease-patient-careDownload

More information can be found here:
Manufacturer Website: https://www.leqembi.com/
Alzheimers Association: https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi
CMS/Medicare Coverage: https://www.cms.gov/newsroom/fact-sheets/cms-announces-new-details-plan-cover-new-alzheimers-drugs
Neurology Live: https://www.neurologylive.com/view/lecanemab-impact-care-diagnosis-future-alzheimer-disease-treatment
Dr Esther Choo: https://www.msnbc.com/opinion/msnbc-opinion/leqembi-alzheimers-drug-benefits-expectations-rcna93524
NEJM Original Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2212948