Update on Alzheimer’s Disease Therapy and Prevention Strategies
Abstract
Alzheimer's disease (AD) is the primary cause of age-related dementia. Effective strategies to prevent and treat AD remain elusive despite major efforts to understand its basic biology and clinical pathophysiology. Significant investments in therapeutic drug discovery programs over the past two decades have yielded some important insights but no blockbuster drugs to alter the course of disease. Because significant memory loss and cognitive decline are associated with neuron death and loss of gray matter, especially in the frontal cortex and hippocampus, some focus in drug development has shifted to early prevention of cellular pathology. Although clinical trial design is challenging, due in part to a lack of robust biomarkers with predictive value, some optimism has come from the identification and study of inherited forms of early-onset AD and genetic risk factors that provide insights about molecular pathophysiology and potential drug targets. In addition, better understanding of the Aβ amyloid pathway and the tau pathway-leading to amyloid plaques and neurofibrillary tangles, respectively, which are histopathological hallmarks of AD-continues to drive significant drug research and development programs. The main focus of this review is to summarize the most recent basic biology, biochemistry, and pharmacology that serve as a foundation for more than 50 active advanced-phase clinical trials for AD prevention and therapy.
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Current targeted therapeutic strategies have failed to slow cognitive decline in AD.
“Current targeted therapeutic strategies have failed to slow down cognitive decline in AD (Graham et al., 2017; Huang and Mucke, 2012), raising concerns about these hypotheses and calling for a broad understanding of molecular and cellular components in AD brain, at both asymptomatic and symptomatic stages during the disease progression (De Strooper and Karran, 2016).”
From Deep Multilayer Brain Proteomics Identifies Molecular Networks in Alzheimer’s Disease Progression (2020) · cites this paper as Graham et al., 2017
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- Authors
- Graham, W. V., Bonito-Oliva, A., & Sakmar, T. P.
- Affiliations
- Rockefeller University (US)
- Karolinska Institutet (SE)
- Venue
- Annual Review of Medicine
- Publisher
- Annual Reviews
- Published
- 2017-01-14
- Volume
- 68
- Issue
- 1
- Pages
- 413-430
- ISSN
- 0066-4219 (ISSN-L)
- 1545-326X
- OpenAlex
- W2462234872
- Cited by
- 506
- References
- 102
- Citations by year
- 2026: 12 · 2025: 25 · 2024: 55 · 2023: 44 · 2022: 64 · 2021: 58 · 2020: 90 · 2019: 71 · 2018: 58 · 2017: 28
- FWCI
- 8.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annual Review of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
- Keywords
- Alzheimer's disease, Alzheimer's disease treatment, Alzheimer's disease prevention, early-onset Alzheimer's disease, genetic risk factors, amyloid-beta, tau pathology, amyloid plaques, neurofibrillary tangles, therapeutic target, clinical trial design, biomarkers, cognitive decline
- MeSH terms
- Aging, Alzheimer Disease, Animals, Cholinesterase Inhibitors, Humans, Immunotherapy, Memantine, Metabolic Diseases, Neuroimmunomodulation, Amyloid beta-Peptides, Neurofibrillary Tangles, tau Proteins, Microglia, Excitatory Amino Acid Antagonists, Molecular Chaperones, Neurogenic Inflammation
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