Dementia: new treatments for Alzheimer's

In recent years, the treatment of dementia and Alzheimer’s disease has entered a new stage. For the first time, alongside treatments that relieve symptoms, medicine has therapies that can slow the progression of the disease in some patients in the early stages.

Although there is not yet a curative treatment, the progress is real and is supported by international clinical studies.

New treatments for Alzheimer’s: lecanemab and donanemab

Among the most discussed recent advances are two medicines: lecanemab and donanemab.

They belong to a class of treatments that act on the beta-amyloid deposits in the brain, which are involved in Alzheimer’s disease.

Clinical studies have shown that, in patients diagnosed early, these therapies can slow the progression of cognitive decline. The effect is not spectacular, and the therapies do not stop the disease, but they are an important step forward from earlier treatments.

These medicines are used only in the early stage of Alzheimer’s disease (mild cognitive impairment or mild dementia), when the presence of amyloid has been confirmed by tests, and treatment requires MRI monitoring to detect possible side effects in the brain (swelling or small bleeds) early.

Early diagnosis: blood tests for Alzheimer’s

Another important direction is the development of blood biomarkers for Alzheimer’s.

These tests can identify biological changes associated with the disease before the symptoms become severe, which could allow:

• faster diagnosis;
• an earlier start to treatment;
• more effective monitoring of patients at risk.

At present, these tests do not replace clinical assessment, but they are becoming increasingly relevant in medical practice.

Which diet helps the brain: nutrition and the risk of dementia

Lifestyle plays an important role in brain health, and diet is one of the most studied factors.

The Mediterranean diet is associated, in numerous studies, with a lower risk of cognitive decline.

It includes:

• vegetables and fruit, regularly;
• fish and olive oil;
• nuts, seeds and pulses;
• wholegrain cereals;
• little ultra-processed food and sugar.

Besides diet, these also matter:

• regular physical activity;
• good-quality sleep;
• blood pressure control;
• an active social life.

What research says about the future of treatments

Current research is moving towards combinations of therapies that target several mechanisms of the disease: the build-up of proteins, brain inflammation and neuronal metabolism.

Another expanding field is the link between the gut microbiome and the brain, which could open new directions for prevention in the future.

Can dementia be slowed?

Medicine’s message today is realistic, but more optimistic than in the past: dementia cannot yet be cured, but in some cases it can be slowed, and early diagnosis is becoming essential.

The earlier the intervention, the better the chances of maintaining cognitive function.

What you can do now

The everyday habits described in this article (diet, physical activity, sleep, blood pressure control and an active social life) play an important part in brain health. You can start with just one, for example, a daily walk. If you notice memory problems that are getting worse, talk to a doctor early.