Pharmacological Approaches in Alzheimer's Disease: From Symptomatic Care to Future Disease Modification

Alzheimer’s disease (AD) is the most prevalent cause of dementia worldwide, posing immense medical, social, and economic challenges. Despite decades of research, pharmacological management has largely remained limited to symptomatic treatments, with cholinesterase inhibitors and NMDA receptor antagonists providing modest benefit. However, recent advances in understanding AD pathophysiology—particularly amyloid-β aggregation, tau pathology, neuroinflammation, and vascular contributions—have led to the development of disease-modifying therapies (DMTs). Monoclonal antibodies such as aducanumab, lecanemab, and donanemab have shown potential to slow cognitive decline, though challenges of safety, cost, and accessibility persist. Parallel research into anti-tau strategies, immunotherapies, multi-target drugs, and precision medicine approaches holds further promise. In addition to pharmacological interventions, non-pharmacological strategies—including lifestyle modifications, dietary interventions, physical activity, cognitive training, and psychosocial support—remain essential for holistic management of AD. Looking forward, advances in biomarker-guided therapy, stem cell research, gene editing, and artificial intelligence are shaping the future landscape of AD treatment. While curative therapies remain elusive, the convergence of pharmacological innovation with preventive and supportive strategies offers renewed hope for patients and caregivers. This review synthesizes current knowledge, highlights recent pharmacological advances, and explores future directions in the management of Alzheimer’s disease.