Travel barriers to amyloid-targeting infusion access among older adults.

Authors

Jeremy Burke, Albert Weerman, Mark Hanson, Quanwu Zhang, Amir Abbas Tahami Monfared, Soeren Mattke

Published in

Alzheimer's & dementia (New York, N. Y.). Volume 12. Issue 2. Pages e70282. Epub Jun 22, 2026.

Abstract

Amyloid-targeting treatments (ATT) for Alzheimer's disease require regular infusions and caregiver accompaniment for approximately 80% of patients. Travel time to infusion sites and caregiver availability can therefore impede access to care, especially in rural and lower income populations.
We conducted a survey in a nationally representative Internet panel with more than 2300 adults aged ≥65 years to estimate willingness to travel for bi-weekly infusion treatment, and access to an accompanying caregiver. Addresses of respondents and infusion sites were geocoded and driving times to the nearest infusion centers were calculated using Google Maps road network data. To estimate potential access gains under subcutaneous (SC) delivery, we estimated access by relaxing the travel and accompaniment requirements in a scenario analysis.
Median willingness-to-travel time was 97.5 minutes (interquartile range [IQR]: 67.5-187.5 minutes) one way for bi-weekly infusions over a 5-year period. Approximately 90% of respondents were willing to travel the required time to reach an infusion site. However, 18% indicated that it would be unlikely that they could identify someone to accompany them. When caregiver accompaniment was incorporated as a constraint, 75% met both the travel and caregiver criteria. In regression analysis, respondents with annual incomes above $60,000 and those residing in metropolitan areas were 9 and 19 percentage points more likely, respectively, to meet travel and caregiver criteria. In a scenario analysis, SC delivery increased overall access by up to 33%, in relative terms, with larger proportional gains for low income and rural respondents.
A meaningful number of individuals in a nationally representative sample live farther from their nearest site than they would be willing to travel, and obstacles to access worsen if individuals need a caregiver to accompany them, as is common among early-stage AD patients. Treatments that do not require infusion delivery could improve equitable access to care.

PMID:
42339401
Bibliographic data and abstract were imported from PubMed on 24 Jun 2026.

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