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<p>The past several decades have yielded deeper insights into the multifactorial pathogenesis and intervention strategies of Alzheimer’s disease (AD). AD pathogenesis involves a complex interplay of multiple factors, where the amyloid-beta hypothesis centers on abnormal Amyloid <i>β</i> (Aβ) aggregation triggering neurotoxicity, and the tau hypothesis focuses on hyperphosphorylated tau forming neurofibrillary tangles (NFTs), while key risk modifiers, including the Apolipoprotein <i>E</i> (APOE4) allele, neuroinflammation, and vascular impairment, further exacerbate disease progression. This review addresses the advancement of AD therapeutic strategies, where Aβ-targeted immunotherapies, such as the approved lecanemab and donanemab, represent a major breakthrough by clearing amyloid plaques and slowing cognitive decline, though requiring careful monitoring for adverse effects like amyloid-related imaging abnormalities (ARIA), and emerging approaches targeting tau pathology and APOE are under active investigation. It is also discussed that non-pharmacological strategies offer crucial complementary value, as integrated lifestyle interventions combining physical exercise, cognitive training, diet adherence, sleep optimization, and social engagement provide multidimensional benefits for disease delay through cost-effective and accessible means, establishing them as fundamental components of comprehensive AD management.</p>

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Advances of therapeutic strategies for Alzheimer’s disease

  • 期刊论文

  • 发表日期：

    2025年10月17日

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  • Xing Guo,
  • Ruizhu Yue,
  • Zhenwu Cui,
  • Shuying Wang,
  • Tian Jia,
  • Wenqiang Li,
  • Wei Zhang,
  • Linlin Shan,
  • Chaokun Li

摘要

The past several decades have yielded deeper insights into the multifactorial pathogenesis and intervention strategies of Alzheimer’s disease (AD). AD pathogenesis involves a complex interplay of multiple factors, where the amyloid-beta hypothesis centers on abnormal Amyloid β (Aβ) aggregation triggering neurotoxicity, and the tau hypothesis focuses on hyperphosphorylated tau forming neurofibrillary tangles (NFTs), while key risk modifiers, including the Apolipoprotein E (APOE4) allele, neuroinflammation, and vascular impairment, further exacerbate disease progression. This review addresses the advancement of AD therapeutic strategies, where Aβ-targeted immunotherapies, such as the approved lecanemab and donanemab, represent a major breakthrough by clearing amyloid plaques and slowing cognitive decline, though requiring careful monitoring for adverse effects like amyloid-related imaging abnormalities (ARIA), and emerging approaches targeting tau pathology and APOE are under active investigation. It is also discussed that non-pharmacological strategies offer crucial complementary value, as integrated lifestyle interventions combining physical exercise, cognitive training, diet adherence, sleep optimization, and social engagement provide multidimensional benefits for disease delay through cost-effective and accessible means, establishing them as fundamental components of comprehensive AD management.