Motivation Through Treatment: How Lecanemab Initiation Facilitated Alcohol Cessation and Cognitive Stability in a...

Excessive alcohol use can complicate the management of individuals in the early stages of cognitive decline, as memory impairment may limit the awareness of harmful habits and reduce motivation for behavioral change. Anti-amyloid therapies such as lecanemab have recently become available for early Alzheimer's disease (AD), but their use in individuals with a history of heavy alcohol consumption remains uncommon. Furthermore, the combined impact of abstinence and disease-modifying therapy on clinical outcomes is not well understood. We report the case of a woman in her early 80s initially diagnosed with mild cognitive impairment (MCI), who later progressed to mild AD. Despite repeated counseling, she had persistent difficulties reducing alcohol intake. As her cognitive symptoms worsened, psychiatric intervention and inpatient care were needed to achieve alcohol cessation. With structured support and lifestyle changes, including the involvement of her daughter, her daily routine stabilized. Following the initiation of lecanemab therapy, she maintained abstinence, experienced no significant treatment-related adverse effects, and showed no imaging abnormalities on follow-up MRI. Her Mini-Mental State Examination (MMSE) scores improved after the combined lifestyle and pharmacologic interventions. This case suggests that lifestyle stabilization and lecanemab therapy can work synergistically in individuals with early AD and prior excessive alcohol use. The initiation of regular infusions may have provided both therapeutic and motivational support for maintaining abstinence and daily structure.