What would be your approach to the consideration of the use of antiamyloid monoclonal antibodies for nonamnestic Alzheimer's disease with a positive biomarker for brain amyloid pathology?

Because treatment appropriateness is based on the stage of cognitive impairment, we base our evaluation on whether the patient meets criteria for mild cognitive impairment or early-stage dementia. We do not use cognitive testing cutoffs, even in amnestic Alzheimer's disease, as staging accounts for functional abilities, and other factors (such as language impairment) may affect cognitive test scores. In our anti-amyloid therapy protocols, we use the Quick Dementia Rating System (The Quick Dement...

I agree that appropriateness for Anti-Amyloid therapy is based on clinical stage and not presentation (amnestic vs non-amnestic). We have found, in our market at least, that the insurance companies want to see an MMSE or MOCA score that falls within the published appropriate use guidelines for these drugs. If patients fall out of these windows, often due to language problems, but are still felt to have MCI or early dementia based on their function, it takes a little prodding from one of our prov...