Doctoral researcher Marta Arbizu Gómez analyzes the Consensus Report of the Spanish Society of Neurology (SEN) on the management of new anti-amyloid therapies for Alzheimer’s disease.
Executive summary:
The 2026 Consensus of the Spanish Society of Neurology (SEN) establishes that the arrival of anti-amyloid therapies marks a historic transition from symptomatic treatment to therapies that modify the course of Alzheimer’s disease. For neurorehabilitation professionals, this advance requires ultra-early detection and critical integration between pharmacological treatment and personalized cognitive stimulation to maximize the patient’s functional reserve.
Why do new Alzheimer’s treatments represent a paradigm shift?
For decades, treatment of Alzheimer’s disease has focused primarily on relieving cognitive symptoms through drugs that act on neurotransmission. However, in recent years, new therapies aimed at modifying the course of the disease have emerged.
These include anti-amyloid monoclonal antibodies, such as lecanemab, which aim to reduce the accumulation of β-amyloid protein in the brain. Unlike traditional treatments, these drugs do not only act on symptoms; they aim to slow disease progression.
This new approach also entails a major change in clinical practice. For these treatments to be effective, patients must be identified at early stages, when neuronal damage is still limited.
However, the introduction of these therapies also poses important challenges for healthcare systems, from the availability of diagnostic tests to the reorganization of clinical services.
The consensus report of the Spanish Society of Neurology (SEN) on the incorporation of new treatments for Alzheimer’s disease analyzes precisely these challenges from the perspective of healthcare professionals.
How was this study on new Alzheimer’s treatments conducted?
The report presents the results of a consensus process among neurologists from different Spanish hospitals, with the aim of assessing the impact of new anti-amyloid therapies on clinical practice and healthcare system organization.
To this end, a structured questionnaire was designed addressing different aspects of managing patients with Alzheimer’s disease, including:
- clinical perceptions of new treatments,
- impact on care and organization,
- waiting times,
- availability of diagnostic resources,
- need for multidisciplinary teams,
- economic implications.
The study was conducted in two rounds of surveys following a structured consensus methodology. Consensus was considered to exist when at least 70% of participants agreed in the same direction of response.
This approach made it possible to identify both areas of agreement among specialists and the main points of uncertainty.
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What do the key results of this Alzheimer’s study reveal?
The results show a largely positive perception of the new treatments.
First, there is a very strong consensus among neurologists that these drugs represent a paradigm shift in Alzheimer’s treatment. In addition, a majority of specialists believe that the cognitive improvements observed in clinical trials could be relevant in clinical practice.
There is also agreement that the treatments can be safe when appropriate monitoring protocols are applied. However, questions remain about the balance between benefits and risks, particularly concerning adverse effects known as ARIA (Amyloid-Related Imaging Abnormalities).
From an organizational perspective, experts agree that the arrival of these therapies will increase demand in neurology clinics, which could lead to longer waiting times and greater pressure on services.
They also recognize the key role of primary care in the initial screening of patients, although there is no consensus on whether primary care will be able to adequately filter treatment-eligible cases.
Overall, experts identify several key challenges that will need to be addressed to integrate these therapies into the healthcare system.
| Area | Main challenges identified |
|---|---|
| Neurology | Increased demand for care and longer waiting lists. |
| Diagnosis | Need for biomarkers and neuroimaging tests. |
| Radiology | Increase in MRI scans for monitoring. |
| Primary care | Key role in the initial screening of patients. |
| Healthcare organization | Need for multidisciplinary teams and new care pathways. |
Diagnostic resources and potential bottlenecks
One of the main challenges identified in the report is the availability of diagnostic resources.
Although most centers have tools such as magnetic resonance imaging, PET, or cerebrospinal fluid biomarkers, specialists note that waiting times could become a significant bottleneck.
In many hospitals, the average time to undergo an MRI is around three months, although there is considerable variability between centers.
In addition, the new treatments require regular monitoring with MRI to detect possible adverse effects, which could further increase the workload of radiology departments.
In this context, neurologists anticipate that the greatest increases in activity will occur in three main areas:
- Neurology.
- Radiology.
- Primary care.
The importance of multidisciplinary teams
Another aspect highlighted in the report is the need to strengthen collaboration among different healthcare professionals.
Experts agree that managing these patients will require multidisciplinary teams including:
- neurologists,
- radiologists,
- primary care physicians,
- neuropsychologists,
- laboratory personnel,
- specialized nursing staff.
In addition, there is broad consensus that the neurologist should coordinate this team, ensuring appropriate patient selection, treatment monitoring, and communication among the various services involved.
This multidisciplinary approach is key to ensuring the safe and efficient management of the new treatments.
What are the implications for clinical practice?
The report’s findings suggest that the introduction of disease-modifying therapies will profoundly transform care for Alzheimer’s disease.
The main anticipated changes include:
- Earlier diagnosis: Identifying patients in the early stages will be essential to harness the potential of these treatments.
- Reorganization of the care system: Some experts propose hub-and-spoke organizational models in which referral hospitals handle advanced diagnosis and treatment administration, while other centers participate in patient screening and follow-up.
- Greater coordination among professionals: Collaboration among primary care, neurology, radiology, and other services will be essential to prevent diagnostic delays and ensure equitable access to treatments.
How does this advance relate to NeuronUP?
The arrival of disease-modifying therapies opens new opportunities for an integrated approach to Alzheimer’s disease.
While biomedical advances make it possible to diagnose the disease at earlier stages, cognitive rehabilitation tools play a fundamental role in preserving patients’ functional independence and quality of life.
Platforms such as NeuronUP facilitate the development of personalized cognitive stimulation programs adapted to each patient’s clinical profile. Combined with new pharmacological treatments, these interventions can help maximize therapeutic benefit.
Thus, the future of Alzheimer’s care points toward a multidisciplinary model in which early diagnosis, pharmacological treatment, and cognitive rehabilitation work together in a complementary way.
Conclusion
New anti-amyloid therapies represent one of the most significant advances in Alzheimer’s research in recent decades. However, their clinical implementation poses important challenges for healthcare systems.
The consensus report of the Spanish Society of Neurology shows that, although there is optimism about their therapeutic potential, it will be necessary to adapt care organization, strengthen diagnostic resources, and improve coordination among professionals.
Only through this adaptation will it be possible to fully harness the potential of these treatments and move toward earlier, more personalized care for people with Alzheimer’s disease.
References
- Sociedad Española de Neurología (SEN). Informe de resultados del consenso de gestión hospitalaria sobre la incorporación de nuevos tratamientos para la enfermedad de Alzheimer.
Frequently asked questions about new Alzheimer’s therapies
1. Why do anti-amyloid therapies represent a paradigm shift in Alzheimer’s disease?
Unlike traditional treatments that only relieve cognitive symptoms by acting on neurotransmission, new drugs such as lecanemab are disease-modifying therapies. Their aim is to reduce the accumulation of beta-amyloid protein in the brain to slow the progression of decline. This requires the system to move from a reactive model to one based on ultra-early detection.
2. What are the greatest logistical challenges for Spanish hospitals according to the SEN?
The consensus report of the Spanish Society of Neurology (SEN) highlights three critical bottlenecks:
- Waiting times: The average time to undergo an MRI is approximately three months, making rapid diagnosis and follow-up difficult.
- Access to biomarkers: There is an urgent need to increase the availability of CSF (cerebrospinal fluid) and amyloid-PET testing to confirm the diagnosis.
- Overburdened services: A massive increase in demand is expected in neurology and radiology clinics.
3. Who should be part of the multidisciplinary team for new Alzheimer’s treatments?
Efficient management of these patients requires coordination led by the neurologist and involving the following professionals:
- Neuropsychologists: Essential for diagnostic assessment and monitoring cognitive efficacy.
- Radiologists and laboratory personnel: Key to imaging diagnosis and biomarker assessment.
- Specialized nurses and primary care physicians: Essential for drug administration and initial screening.
4. What is ARIA and how should it be monitored?
ARIA (Amyloid-Related Imaging Abnormalities) are amyloid-related imaging abnormalities that may occur as adverse effects of these therapies. The consensus of the Spanish Society of Neurology (SEN) emphasizes that these drugs can be safe when strict monitoring protocols using periodic MRI scans are applied to detect and manage these complications early.
5. Is cognitive rehabilitation with NeuronUP compatible with new Alzheimer’s drugs?
It is fully complementary and necessary for an integrated approach. While immunotherapy acts on the molecular pathology, platforms such as NeuronUP enable personalized cognitive stimulation programs that help preserve patients’ functional independence and improve their quality of life. The synergy between drugs and nonpharmacological rehabilitation is key to maximizing overall therapeutic benefit.
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