Case Study 3

A retired librarian aged 74 years recently underwent neuropsychological testing for the relatively recent onset of difficulty remembering what she had read and other mild symptoms of "forgetfulness." Her mother and her maternal aunt both had "Alzheimer’s" and she was concerned that she may be in the early stage of the disease. Neuropsychological testing led to a diagnosis of mild cognitive impairment (MCI), and after consultation with a geriatric neurologist, the patient was referred back to her PCP for follow-up. No treatment recommendation was offered, and imaging studies were not performed. The patient returned to her PCP accompanied by her husband and daughter. The patient’s daughter had read about recently approved anti-amyloid beta (Aβ) monoclonal antibodies (mAb) for MCI and mild Alzheimer’s disease (AD), and she asked the PCP for additional information and advice.

How would you facilitate a discussion about the potential benefits and risks of anti-Aβ mAb therapy, including the risk of amyloid-related imaging abnormalities (ARIA)?(Required)