Advances of therapeutic strategies for Alzheimer's disease

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.