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# Physical frailty and faster clinical decline on lecanemab in early Alzheimer's disease
- URL: https://www.coios.me/physical-frailty-and-faster-clinical-decline-on-lecanemab/
- Published: 2026-11-03T12:55:22.000Z
- Updated: 2026-11-03T17:57:23.000Z
- Description: In 187 patients starting lecanemab, physical frailty was linked to faster decline on the CDR-SB and more infusion-related reactions.
- Author: Daniel Ryan
- Tags: Health today, Dementia, Frailty and multimorbidity, South Korea, #peer-reviewed, #new, #item, #source-2026-11, #score-55

A prospective cohort followed 187 amyloid-positive patients with early Alzheimer's disease starting lecanemab at a tertiary memory clinic. Physical frailty was defined by the Short Physical Performance Battery, and sarcopenia by the 2019 Asian Working Group criteria. Frail patients worsened 1.52 points a year faster on the CDR-SB dementia rating, and patients with sarcopenia 1.40 points faster. Frailty was linked to more infusion-related reactions (adjusted odds ratio 4.75), but not to amyloid-related imaging abnormalities or stopping treatment. Neither frailty nor sarcopenia was linked to change in Mini-Mental State Examination score or plasma p-tau217 trajectories. This was a single-clinic study, and imaging abnormality events were too few for standard regression.

*Why it is interesting: Frailty and sarcopenia are known to shape Alzheimer's progression, but their role during anti-amyloid therapy was unclear. Frailty on a simple physical performance test was linked to faster clinical decline and more infusion reactions on lecanemab.*

Source

[Aging and disease, 2 November 2026](https://doi.org/10.14336/AD.2026.0978?ref=coios.me)

Paper

Baseline Physical Frailty Predicts Clinical Outcomes During Lecanemab Therapy in Early Alzheimer's Disease: A Prospective Real-World Cohort Study

Authors

Shin J, Park YJ, Lee S, Kang J, Lee S, Lee ES et al.

DOI

10.14336/AD.2026.0978

Type

Peer-reviewed article

Design

Prospective single-centre real-world cohort, 187 amyloid-positive early AD patients initiating lecanemab; mixed-effects and penalised logistic models

Verdict

New finding

Driver

[Dementia](https://www.coios.me/d-dementia/)

Driver

[Frailty and multimorbidity](https://www.coios.me/d-frailty-multimorbidity/)