Baseline CDR-GS, MMSE Scores May Predict DMT Eligibility Window for Early Alzheimer’s

A study presented at the 2025 meeting of the Alzheimer’s Association International Conference (AAIC) examined the eligibility window of disease-modifying therapies (DMTs) for the treatment of people with early Alzheimer disease (AD). An analysis of the study’s results revealed that higher Clinical Dementia Rating–Global Score (CDR-GS) and lower Mini-Mental State Examination (MMSE) scores at baseline were associated with significantly shorter windows of eligibility for DMT treatment. The findings suggest that baseline MMSE and CDR-GS scores may have potential applications in prioritizing and scheduling DMT treatment for at-risk patients to ensure that they do not become ineligible for therapeutic benefit.

Researchers analyzed data from 2 longitudinal cohorts—the National Alzheimer’s Coordinating Center (NACC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—to assess the duration of eligibility for Leqembi and Kisunla treatment. Inclusion criteria reflected each drug’s approved indication: CDR-GS of 0.5 or 1, MMSE scores of 22 to 30 (Leqembi) or 20 to 28 (Kisunla) and confirmed amyloid positivity.

Key results:

• A CDR-GS baseline score of 1 was associated with nearly twice the risk of early ineligibility compared with a score of 0.5 (hazard ratio [HR], 1.99; 95% CI, 1.64 to 2.43).
• Each 1-point increase in baseline MMSE score corresponded to an HR of 0.70 (95% CI, 0.62 to 0.80).
• According to median survival estimates, individuals with a baseline CDR-GS of 1 lost therapeutic eligibility within 12 months.
• Some individuals with a CDR-GS of 0.5 and higher MMSE scores remained eligible ≤12 months.