Time-saved and time-invested with anti-amyloid treatments in early Alzheimer’s disease: practical considerations

Abstract

Anti-amyloid treatments for early Alzheimer’s disease very effectively remove amyloid deposits from the brain and have shown an approximately 30 % less worsening in cognitive functions compared to placebo. Some additional metrics, such as time-saved, i.e. the additional time people may live independently, have been suggested to better inform patients and the general public about the benefits and risks of these medications. Some authors report 4–6 months, and others 10–13 months, depending on the treatment period, time of follow-up, and the methodology used. Taking into consideration that these drugs’ regimens are monthly or bi-weekly intravenous infusions requiring clinical supervision, and the necessary brain MRIs for follow-up, we argue that the time spent travelling by the patients and their family members should also be taken into consideration when proposing anti-amyloid treatments, and specifically, when discussing the amount of time saved. In this study, we report that nearly half of the possible eligible patients for anti-amyloid treatments experience a reduction in motivation after receiving the information about the number of times required to come to the hospital, especially those travelling long distances (average time: 60 min for one-way). We propose a rough estimate for the additional time patients and their family members are likely to spend in these arrangements and suggest these additional calculations should be part of the decision-making process.