A study published August 5, 2026, in Neurology, the medical journal of the American Academy of Neurology, found that most people with atypical forms of Alzheimer's disease would fail to meet the eligibility criteria for anti-amyloid therapies, the newer drugs designed to slow the disease's progression.
Atypical Alzheimer's refers to presentations that begin with problems in thinking, language or vision rather than the memory loss most people associate with the disease. Because anti-amyloid treatments are intended to be given early, and eligibility is often anchored to the first signs of memory trouble, patients whose symptoms started elsewhere can be screened out even when their disease is still at an early stage.
That mismatch has practical consequences. A person with progressive language decline or visual processing problems driven by Alzheimer's pathology may be biologically similar to a candidate who qualifies, yet be turned away on the basis of how their symptoms happen to present. Study author Dror Shir, MD, of the Mayo Clinic in Jacksonville, Florida, and a member of the American Academy of Neurology, said the findings suggest treatment criteria may unintentionally exclude many of these patients.
The broader context is that atypical Alzheimer's has long been underrecognized in clinical practice and underrepresented in the trials that shaped today's treatment criteria. The findings point toward a need to revisit how eligibility is defined so that the drugs reach patients who fit the biology of the disease, not just its most familiar symptom pattern.