Alzheimer’s treatment is changing – at Aava, a new drug treatment is part of a carefully designed care model

For a long time, Alzheimer’s disease has mainly been treated by relieving symptoms. This is now beginning to change. The new medicine, lecanemab (Leqembi), targets amyloid plaques that accumulate in the brain and are linked to the progression of the disease.

– This is the first treatment that aims to affect the course of the disease itself, not just the symptoms, says neurologist Markus Wiksten.

The change also means that, in addition to symptomatic treatment and rehabilitation, it is now possible to influence the pathological mechanism of the disease itself. However, the treatment should not be provided as a stand-alone intervention, but as part of a broader care model.

Treatment is planned individually – the same solution is not right for everyone

The new treatment is intended for early-stage Alzheimer’s disease. This makes timing a key factor.

– The effectiveness of the treatment is linked to starting it early enough. At the same time, it is important to identify situations where another care pathway would be better for the patient.

The first step is not to start treatment, but to carry out a careful assessment together with a specialist.

The diagnosis is confirmed as accurately as possible

At Aava, the treatment is based on a comprehensive diagnostic assessment. This includes a clinical evaluation, a memory assessment carried out by a neuropsychologist, imaging examinations, biomarker tests and blood tests, including ApoE4 genotype testing.

A key part of the diagnostic process is a cerebrospinal fluid sample, which is analysed for biomarkers associated with Alzheimer’s disease, such as amyloid and tau proteins.

“In practice, this means that the diagnosis is not based on symptoms alone, but can be supported by biological evidence. This helps confirm that the memory symptoms are caused specifically by Alzheimer’s disease and its pathology, rather than by another condition causing memory problems.”

The care pathway is designed so that the patient is not left alone

At Aava, the treatment is not based on a single procedure, but on a comprehensive care model in which the patient is supported throughout the treatment. The decision to start treatment is made by a multidisciplinary expert team, after which the patient proceeds through the care pathway step by step.

In addition to regular infusion treatments, the care pathway includes imaging follow-ups and memory assessments to ensure the safety of the treatment and monitor the progression of the disease.

– This is not a treatment where the patient is left alone with medication. Every stage is planned and monitored carefully, says Wiksten.

During treatment, the patient also has a named contact person: Aava’s memory care nurse. The patient can contact the nurse if there are any changes in their condition. The memory care nurse is closely involved in the patient’s care and is therefore a familiar person the patient can turn to if they have concerns or questions.

Close monitoring provides safety – changes are acted on quickly

The treatment can cause side effects, such as brain swelling and bleeding in the brain. For this reason, patients are monitored regularly according to a defined protocol with brain imaging, memory assessments and functional capacity assessments.

Fortunately, recent international experience has shown that most side effects are mild or asymptomatic, and treatment can often continue as planned.

– The purpose of monitoring is to make sure the treatment progresses safely. If changes occur, they can be acted on quickly, says Wiksten.

The care model has been developed together with experts

The care model introduced at Aava has been developed in cooperation with memory disorder specialists. Its implementation takes into account both national and international expert recommendations.

At Aava, stricter-than-usual criteria have been set for starting treatment. This helps ensure that the treatment is offered only to patients with early-stage Alzheimer’s disease and mild symptoms.

For everyone being considered for the new treatment, biomarker tests are carried out using both blood and cerebrospinal fluid samples to confirm the diagnosis.

When should you seek assessment?

Because the treatment is effective only in the early stage of the disease, seeking assessment at the right time is essential.

It is advisable to seek assessment especially if memory problems begin to affect everyday life, or if close family members or friends notice changes.

– The first changes are often very ordinary, such as repeating the same thing or forgetting conversations. They may also include mistakes in routine tasks, such as forgetting to pay bills or having difficulty managing them. At first, these may occur only occasionally, but if and when they start to happen repeatedly, it is better to react too early than too late.

A significant step, but not yet a solution for everyone

The new treatment is not suitable for everyone and is not yet widely available. Even so, it marks a clear step forward in the treatment of Alzheimer’s disease.

– This is the beginning. In the future, more similar treatments will become available, and biomarkers will play an increasingly important role in treatment decisions and in selecting the right treatment at the right time. Future treatments may perhaps begin to resemble today’s cancer treatments, where care is combined and staged individually according to the pathological profile of the disease, Wiksten says.