Pharmacological Targets and Therapeutic Strategies in Alzheimer's Disease: Mechanistic Insights and Emerging Drug Approaches—A Narrative Review

Alzheimer's disease, a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and neuronal death, has multiple inter-connected mechanisms that contribute to its pathogenesis (the largest factor being amyloid beta accumulation; however, other factors such as hyperphosphorylated tau protein accumulation, oxidative stress, mitochondrial dysfunction, and inflammatory response are also involved). Currently available drug treatments, such as cholinesterase inhibitors and NMDA receptor antagonists, relieve symptoms but do not significantly influence the progression of the disease itself. Increased knowledge regarding the relevant molecular pathways involved in the pathogenesis of the disease has led to the recent development of additional potential pharmaceutical targets that may be used to create more effective therapies aimed at delaying or preventing Alzheimer's Disease. New strategies are emerging for the development of treatment approaches that include anti-amyloid and anti-tau treatment approaches, inhibition of kinases, neuroprotective agents, and modulation of inflammatory signaling pathways. Overall, this review covers the major pharmacological targets that have been identified in Alzheimer's disease as well as the current treatments available for the disease, discusses the limitations of those treatments, and presents recent advances in the development of therapeutics to modify the pathological processes associated with Alzheimer's disease. Understanding these pharmacological strategies will ultimately improve the ability to develop therapeutics for delaying or halting the progression of Alzheimer's disease.