1- A thread on the value of treating #Alzheimer’s disease w/ monoclonal antibodies:

As I read through the recently published appropriate use guidelines for #lecanemab, I am struck by the infrastructure & resources that will be necessary.

#GeriTwitter

link.springer.com/article/10.142…. 2- This table summarizes what medical centers need to safely administer lecanemab to people with Alzheimer’s disease.

Lecanemab is given via IV infusion every two weeks. This requires having an infusion center with the needed capacity & appropriately trained staff.

Americans’ life expectancy is plummeting. The graphic is stunning.

“American life expectancy is lower than that of Cuba, Lebanon, and Chechnya.”

#MedTwitter

npr.org/sections/healt… Why?

“Yes, Americans eat more calories and lack universal access to health care. But there's also higher child poverty, racial segregation, social isolation, and more. Even the way cities are designed makes access to good food more difficult.”

We are honored to welcome Dr. Holly Swartz, Prof of Psychiatry at @PittPsychiatry & Editor-in-Chief of American Journal of Psychotherapy (@APA_Publishing) to @uwsmph @UWHealth Psychiatry Grand Rounds to discuss:

"Psychosocial Interventions for #Bipolar Disorder"

#PsychTwitter Network meta-analysis indicated that psychotherapy, including CBT, family focused therapy, and interpersonal & social rhythm therapy (IPSRT), are effective interventions for bipolar depression and for prevention of recurrence of bipolar disorder.

ncbi.nlm.nih.gov/pmc/articles/P…

1- My current take on whether anti-amyloid therapies are likely to have meaningful impact on cognition, functioning & quality of life of people living w/ #dementia due to #Alzheimers disease:

Not likely.

For details, based on my recent Grand Rounds at Penn St, read on. 2- History:

After finding that active immunization with Abeta42 in mice that overexpressed APP resulted in virtual elimination of amyloid deposits, there was great enthusiasm for anti-amyloid therapies - and for the amyloid hypothesis.

pubmed.ncbi.nlm.nih.gov/10408445/

1- Detailed & persuasive critique by Dr. @LonSchneiderMD of the #aducanumab esults recently published in the J of Prevention of #Alzheimers Disease.

#GeriTwitter

link.springer.com/article/10.142… @LonSchneiderMD 2- Note that the assn. between amyloid reduction & cognition goes in opposite directions in the 2 studies:

"High dose aducanumab was about as cognitively impairing in ENGAGE as it was beneficial in EMERGE [despite] both trials showing similar, substantial reductions in plaque."