The importance of non-pharmacological interventions to improve cognitive reserve prior to the administration of a drug against the causative agent of Alzheimer's disease.

Abstract

Lecanemab, an antibody drug targeting amyloid-β, has been approved to treat Alzheimer's disease (AD) in the United States and Japan recently. However, there are several concerns about Lecanemab, such as its minimum biological effects, possible side effects, and its economic burden. On the other hand, non-pharmacological approach without major side effects has a potential to alleviate the symptoms of AD by improving cognitive reserve, which is individual's resilience to AD pathology. It is important to compare the benefits and risks of pharmacological and non-pharmacological approaches, especially in the oldest old with AD, to give priority to the safe and cost-effective approach.