Neurology

Cardiovascular events may limit anti-amyloid therapy use in older adults

March 13, 2026

A longitudinal cohort study of 12,373 older adults in the Health and Retirement Study found that patients with mild cognitive impairment (MCI) or dementia frequently developed new cardiovascular conditions requiring anticoagulants or thrombolytics—therapies that may contraindicate anti‑amyloid monoclonal antibodies (mAbs). Over one year, individuals with MCI had a 5.7% cumulative risk of developing any new indication, rising to 6.7% among those with dementia. Stroke (2.0%–2.4%) and afib (1.7% across both groups) were the most common events, with additional risks observed for deep vein thrombosis, pulmonary embolism, and acute MI.

Clinical takeaway: For patients being considered for anti‑amyloid mAbs, reassess cardiovascular status regularly and discuss the possibility that new anticoagulation needs may emerge and affect treatment eligibility.

Source:

Parks AL, et al. (2026, January 27). Neurology. Risk of New Indications for Anticoagulants and Thrombolytics in People With Cognitive Impairment: Implications for Anti-Amyloid Therapy. https://pubmed.ncbi.nlm.nih.gov/41461060/