Alzheimer's Disease (AD)
Patient Condition
The patient developed mild memory loss at the age of 68 and was diagnosed with mild Alzheimer's disease at the age of 69 (MMSE 22 points, CDR 0.5). At diagnosis, MMSE was 18 (decreased by 4 points within 1 year), ADAS-Cog was 18, CSF Aβ42 320 pg/mL (decreased), tau 92 pg/mL (increased), and p-tau 28 pg/mL. Homozygous carriers of ApoE4 have a high risk of disease progression. Having been using donepezil + memantine for 1 year, cognition continues to decline (annual decrease in MMSE is about 4 points). The hippocampal volume was reduced by 28% compared with the same age control. FDG-PET showed decreased metabolism in bilateral temporal and parietal lobes.
Treatment Timeline
| Phase | Details | Date |
|---|---|---|
| Comprehensive evaluation and precise treatment plan formulation | ||
| Lecanemab anti-A β therapy initiated | ||
| tau ASO combination therapy + cognitive rehabilitation | ||
| Maintenance treatment and functional maintenance |
Treatment Outcome
| before | MMSE 18 points, annual decline 4 points, ApoE4 homozygous, high amyloid load (PET SUVr 2.1), 28% reduction in hippocampal volume, ADL 72 points, rapid cognitive decline |
|---|---|
| after | MMSE 15 points, annual decline rate reduced to 1.5 points, plaque reduction by 19%(SUVr 1.7), ADL improved to 75 points, cognitive decline rate reduced by 73%, and biomarkers significantly improved |
| highlight | Anti-A β+tau dual-targeted combination therapy reduced the rate of cognitive decline by 73%, significantly improved biomarkers, and achieved functional maintenance and improved quality of life in patients with advanced AD |