Alzheimer’s Drugs Leqembi (lecanemab) & Kisunla (donanemab): Why Removing Amyloid May Not Be Enough

Why is it that anti-amyloid Alzheimer's drugs like Leqembi (lecanemab) and Kisunla (donanemab) can remove amyloid from the brain — BUT still not make the difference in cognition families were hoping for? In this episode, I walk you through the Alzheimer's disease timeline so you can understand what's already happening in the brain by the time symptoms appear — and why that changes everything about how we think about these drugs. 📥 Download the free RESTORED Protocol for the essential 8 evidence-based lifestyle factors for brain health at amylangcoaching.com --- IN THIS EPISODE, we discuss: ✦ The amyloid cascade hypothesis — what it is, why it made sense, and what the Cochrane Review's own authors said about it ✦ The disease timeline — why Alzheimer's starts 10 to 20 years before symptoms appear, and what amyloid, tau, and neuroinflammation each contribute ✦ Why tau may matter more than amyloid by the time symptoms show up — and what that means for drug efficacy ✦ The real numbers on lecanemab and donanemab — 27% and 35% slowing of decline, what that looks like over 18 months, and why slowing is not the same as reversing ✦ Neuroinflammation — why the Cochrane Review authors said future research should focus on other mechanisms of action ✦ Nine questions to bring to your next neurology appointment if a loved one is being offered one of these drugs ✦ The AHEAD trial — what it's testing, why it matters, and what it tells us even before results come in ✦ What the highest-quality lifestyle evidence says you can do right now — regardless of diagnosis --- RECOMMENDED EPISODES: 👉 Ep 337: The Cochrane Review on Alzheimer's Drugs — What It Really Means —    • Do Anti-Amyloid Drugs Leqembi (lecanemab) ...   👉 Ep 336: APOE4, GLP-1s, and Alzheimer's Risk —    • APOE4, GLP-1s, and Alzheimer's Risk: Hope,...   --- REFERENCED in this episode: ● Amyloid cascade hypothesis and biomarker timeline: Sperling et al. (2011), Alzheimer's & Dementia — https://doi.org/10.1016/j.jalz.2011.0... ● Cochrane Review: Monoclonal antibodies for Alzheimer's disease (published April 16, 2026) — https://doi.org/10.1002/14651858.CD01... ● Lecanemab (Leqembi) trial — CLARITY AD: https://www.nejm.org/doi/full/10.1056... ● Donanemab (Kisunla) trial — TRAILBLAZER-ALZ 2: https://www.nejm.org/doi/full/10.1056... ● AHEAD 3-45 Trial (lecanemab in preclinical Alzheimer's): https://pmc.ncbi.nlm.nih.gov/articles... ● FINGER Study: https://fbhi.se/the-finger-study/ ● U.S. POINTER Study: https://uspointer.net/home.cfm ● Lancet Commission Report on Dementia Prevention 2024: https://www.thelancet.com/journals/la... ● Ornish-Tanzi lifestyle trial: https://pmc.ncbi.nlm.nih.gov/articles...