Case Study 3

A retired sales executive aged 78 years with knee osteoarthritis and a 1-year history of progressive difficulty recalling recent conversations, names, and events was referred by his PCP for neuropsychologic evaluation. He underwent a detailed neurocognitive assessment including the Clinical Dementia Rating (a 5-point scale used to characterize 6 domains of cognitive and functional performance) followed by a brain MRI scan, which demonstrated diffuse atrophy and white matter changes considered normal for age. He was not an ApoE ε4 carrier. At a follow-up consultation with the patient and his family, his neurologist discussed management options, which included treatment with a cholinesterase inhibitor such as donepezil or rivastigmine, a glutamate regulator (memantine), and an anti-amyloid beta monoclonal antibody (Aβ mAb) such as aducanumab or lecanemab. After considering all options including the potential benefits and risks of each, the patient agreed to begin treatment with donepezil and aducanumab.

How would you monitor him for amyloid-related imaging abnormalities (ARIA) after treatment begins?(Required)