Logical memory is associated with amyloid-β positivity in patients with early Alzheimer's disease eligible for lecanemab

BackgroundLecanemab is an anti-amyloid monoclonal antibody, approved for early Alzheimer's disease (AD), with evidence indicating greater benefit at earlier stages. Sensitive cognitive measures are needed to identify underlying amyloid pathology.ObjectiveTo investigate whether the Logical Memory (LM) subtest of the Wechsler Memory Scale-Revised (WMS-R) can help characterize amyloid positivity in lecanemab-eligible individuals.MethodsWe retrospectively analyzed 91 individuals who attended our center between December 2023 and March 2025; 45 met eligibility criteria (Mini-Mental State Examination ≥ 22, Clinical Dementia Rating 0.5 or 1.0, magnetic resonance imaging compatibility). Amyloid status was determined by positron emission tomography, classified as amyloid-positive (Aβ+, n = 35) or amyloid-negative (Aβ-, n = 10). All participants underwent neuropsychological assessment, including LM. Groups were compared, and LM Aβ status discrimination was evaluated using receiver operating characteristic analyses and multivariable logistic regression.ResultsGroups did not differ in age, sex, or education. LM immediate (LMIR) and delayed recall (LMDR) scores were lower in the Aβ+ group (LMIR median: 5.0 versus 9.0, p = 0.011; LMDR: 0.5 versus 3.0, p = 0.017). Receiver operating characteristic analyses identified cutoffs of 7.5 for LMIR (area under the curve [AUC]: 0.79, sensitivity: 79%, specificity: 77%) and 1.5 for LMDR (AUC: 0.76, sensitivity: 75%, specificity: 77%). Lower LM scores were associated with increasing amyloid positivity. Logistic regression showed significant associations for both LMIR and LMDR (odds ratio: 0.80 and 0.64, 95% confidence interval: 0.64-0.95 and 0.38-0.91, respectively).ConclusionsWMS-R LM scores were significantly associated with amyloid-β accumulation in individuals with early AD meeting lecanemab eligibility criteria.