Faculty Sponsor

Jana Stedman

College

College of Nursing & Health Professions (CONHP)

Department/Program

Master's of Physician Assistant Studies

ORCID Identifier(s)

https://orcid.org/0009-0008-2565-2001

Presentation Type

Poster Presentation

Symposium Date

Summer 7-23-2025

Abstract

This research evaluates and compares the effectiveness of monoclonal antibodies (mAbs) and cholinesterase inhibitors (ChEIs) in reducing cognitive decline in Alzheimer’s disease. A structured literature review was conducted using Google Scholar and Medline, yielding over 6,000 articles. Studies were included if they involved Alzheimer’s patients, evaluated either mAbs or ChEIs, measured cognitive outcomes, were published since 2019, and were available in English with full-text access. Studies were excluded if they focused on non-Alzheimer’s populations, alternative therapies, or were published before 2019. Monoclonal antibodies such as aducanumab, lecanemab, and donanemab showed statistically significant improvements in cognitive scores; however, these changes were clinically modest and often accompanied by amyloid-related imaging abnormalities (ARIA) and other adverse events. In contrast, ChEIs including donepezil, rivastigmine, and galantamine demonstrated more consistent, modest cognitive benefits with fewer safety concerns. ChEIs also have a longer history of use and are generally better tolerated and more cost-effective. The review revealed a lack of head-to-head comparative studies and limited data on long-term outcomes or diverse populations. Although mAbs offer a novel mechanism by targeting amyloid plaques, their clinical utility remains constrained by safety risks and high costs. ChEIs remain the more practical, accessible, and reliable first-line treatment for managing cognitive symptoms in Alzheimer’s disease. Further research is needed to directly compare these therapies, assess long-term effects, and improve representation across different patient groups.

Biographical Information about Author(s)

Alexandra Herbert is a student in the Valparaiso University Physician Assistant Program. She has a special interest in Endocrinology and plans to work in Primary Care following graduation. Alexandra will be presenting on “Monoclonal Antibodies or ChEIs? Cognitive Impact in Alzheimer’s,” a topic inspired by her passion for exploring Alzheimer’s treatment efficacy and her years of experience working as a nursing assistant in memory care.

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