21 September 2026

World Alzheimer’s Month: Where are we in the search for a cure?

AZ month title

As the global incidence of Alzheimer’s disease continues to rise, predicted to reach 139 million by 2050 [1], the need for effective treatments has never been greater. This urgency is reflected in the estimated $42 billion spent on Alzheimer’s research and development over the past three decades [2], yet there remains no cure. As part of World Alzheimer’s Month, this September we take a closer look at the evolving research and treatment landscape to consider what a cure for Alzheimer’s disease might look like. 

What makes Alzheimer’s disease so difficult to treat? 

Characterised by the progressive death of neurons (neurodegeneration), Alzheimer’s disease has long been attributed to the pathological accumulation of two proteins in the brain: amyloid-beta and tau. In recent years, widespread understanding has expanded beyond this traditional ‘amyloid hypothesis’. The immune system, blood flow, metabolism, genetics, protein degradation and even environmental factors are all increasingly thought to play a role in Alzheimer’s disease progression. The exact interactions and sequences of these processes remain unclear and may vary between individuals, complicating the identification of effective drug targets [3]. 

Before use in humans, potential treatments must be tested using disease models. It can be particularly challenging for preclinical researchers to recreate the complex, multifactorial features of human Alzheimer’s disease in cell cultures or genetically modified animals. This may explain, in part, why several Alzheimer’s treatments initially produce promising results in laboratory studies, only to fail in late-stage clinical trials [2].  

Complex study designs, lengthy trial periods and challenges in recruiting and retaining suitable participants make Alzheimer’s disease clinical trials more expensive than those in any other therapeutic area [4]. Coupled with the historical uncertainty of commercial or clinical success, this may discourage investment in Alzheimer’s drug development [5]. 

Even if an effective treatment becomes available, patient outcomes may depend on the timing of diagnosis and intervention. Notably, Alzheimer’s disease–related changes in the brain can begin decades before observable deficits in memory or cognition emerge [6]. With current strategies for diagnosis limited to review of patient histories, cognitive assessments and neurological examinations, many individuals with Alzheimer’s disease are only diagnosed after significant, potentially irreversible neurodegeneration has already occurred (Figure 1) [7].  

figure 1

Figure 1: Typical timeline of cognitive decline and neurodegeneration across the stages of Alzheimer’s disease, showing that changes in the brain begin before significant impairment of cognitive function, with diagnosis generally occurring after the onset of neurodegeneration. 

Current approaches to treating Alzheimer’s disease  

Existing treatments primarily focus on managing symptoms rather than targeting the underlying causes of Alzheimer’s disease. For example, cholinesterase inhibitors have been used in clinical practice for over two decades to help manage the progressive loss of neurons that produce acetylcholine (ACh) – a chemical messenger involved in memory and learning. These drugs slow the breakdown of ACh, increasing its availability without addressing underlying neurodegeneration [8]. Another approved treatment helps to regulate excessive neuronal activity in Alzheimer’s disease by blocking the effects of the excitatory neurotransmitter glutamate. Cholinesterase inhibitors and glutamate receptor antagonists are commonly prescribed together and can temporarily slow decline in memory and cognitive function [9]. Other medicines, including selective serotonin reuptake inhibitors (SSRIs), may also be used to manage associated behavioural symptoms of Alzheimer’s disease, including depression and anxiety [10]. 

Given the limitations of these symptom-based treatments, research has increasingly focused on developing disease-modifying therapies (DMTs), which aim to slow Alzheimer’s disease progression by directly targeting the underlying biological processes. The recent emergence of anti-amyloid monoclonal antibodies (mAbs), the first and currently the only approved DMTs for Alzheimer’s disease, represents a major milestone in the research landscape. These drugs promote the clearance of amyloid-beta protein aggregates that accumulate between the neurons of Alzheimer’s patients. The first treatment in this class received accelerated approval from the US Food and Drug Administration (FDA) in 2021 but was later discontinued following strategic reprioritisation by the manufacturer [11]. Since then, two newer mAb therapies have been licensed for the treatment of early Alzheimer’s disease in several countries, including the US and UK. Both have demonstrated substantial amyloid clearance alongside modest slowing of cognitive and functional decline [12]. 

Despite their promise, anti-amyloid monoclonal antibodies do not constitute a cure for Alzheimer’s disease, slowing rather than preventing or reversing disease progression [12]. Their use is also limited by high costs and an associated risk of swelling or bleeding in the brain. Moreover, as their efficacy is largely limited to early-stage Alzheimer’s, clinical success relies on timely diagnosis [12]. 

Advances in Alzheimer’s disease diagnosis  

Improved detection of Alzheimer’s disease may be supported by growing efforts to identify new biomarkers: measurable biological signs of disease. Magnetic resonance imaging (MRI) and positron emission tomography (PET) scans can help to identify Alzheimer’s disease–related changes in brain structure or protein deposition but often struggle to differentiate between types of neurodegenerative diseases [13]. Compared with invasive sampling of the cerebrospinal fluid (CSF), which surrounds the brain and spinal cord, blood-based biomarkers constitute a more accessible, affordable alternative. Blood tests can detect markers of neuronal damage and inflammation, as well as disease–associated forms of amyloid and tau, with phosphorylated tau (p-tau217) recently emerging as a particularly promising Alzheimer’s disease biomarker [14]. 

The future of Alzheimer’s disease treatment 

Despite the aforementioned challenges, the Alzheimer’s disease treatment pipeline remains active, with a handful of novel disease-modifying therapies progressing through late-stage clinical development. For example, following evidence of potential cognitive benefits in Phase III testing, an investigational therapy that inhibits tau protein aggregation has recently been submitted for UK authorisation in mild-to-moderate Alzheimer’s disease [15]. Another promising therapy targets messenger RNA to reduce the production of Alzheimer’s disease–associated proteins. Based on encouraging results in patients with mild Alzheimer’s, recruitment has begun for a Phase III trial of this drug [16]. Together, these emerging approaches reflect a shift towards targeting a broader range of Alzheimer’s disease pathways, beyond the clearance of established amyloid deposits. 

A potentially more cost-effective strategy is drug repurposing, whereby medicines already approved for other conditions are investigated for use in Alzheimer’s disease. Candidates showing cognitive benefits in Phase II trials include anti-seizure drugs [18], GLP-1 receptor agonists [19], and phosphodiesterase inhibitors [13]. Many of these are being investigated as multi-target Alzheimer’s disease treatments, with reported effects on neuronal hyperexcitation, protein aggregation, cerebral blood flow and neuroinflammation [13,17]. At present, results from emerging and repurposed treatments remain largely mixed, with long-term efficacy and safety across diverse patient populations yet to be established.  

With approximately one third of Alzheimer’s disease cases worldwide strongly linked to modifiable risk factors [20], future strategies may also extend beyond pharmacological treatment to include preventive lifestyle and behavioural interventions. 

Rethinking the search for a cure 

Emerging evidence increasingly points to multiple interacting biological processes underlying Alzheimer’s disease progression, challenging the idea of a single universal cure. Instead, the future of treatment may lie in precision medicine, using biological and genetic profiles to select combination therapies tailored to the individual. With continued investment, there is hope for advancements in disease modelling, diagnosis and multi-target therapies that may help address the rising global prevalence of Alzheimer’s disease [1]. 

The information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content is for general information purposes only. Always seek the guidance of your doctor or other qualified healthcare professional with any questions you may have regarding your health or medical condition. 

#AlzheimersAwarenessMonth2026 #AlzheimersResearch #Neurodegeneration #FightAlzheimers

 

References 

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