Emerging disease modifying therapies for older adults with Alzheimer disease: perspectives from the EuGMS special interest group in dementia

The advent of DMT in AD is a welcome development but the real-world benefit of these medications for older adults is yet to be determined. For geriatricians, AD significantly contributes to later-life rates of institutionalisation, frailty, falls, continence issues and other geriatric syndromes associated with diminished quality of life. We must consider the potential effect of any potential DMT on these important outcomes and advocate for their inclusion in clinical trials alongside traditional gold-standard dementia severity assessments. As geriatricians, there must be a delicate balance between advocating for timely access to any potential DMT which may benefit older adults with AD and advocacy for continued and enhanced supportive care pathways for older adults with more advanced AD or more significant levels of frailty who may not be eligible for new DMT. Whilst the needle has indeed been moved by the potential emergence of DMT, we must ensure that older adults with more severe AD are not left behind and cautiously evaluate the real-world clinical impact of potential DMT on gerontologically-focussed outcomes which are important to older adults, their caregivers and clinicians alike.