In 2024, several new drugs are being tested to target the underlying causes of Alzheimer’s, such as the accumulation of amyloid plaques and tau tangles in the brain. One of the most notable breakthroughs has been the use of monoclonal antibodies (man-made proteins that act like human antibodies in the immune system) that can help clear amyloid plaques, which are thought to disrupt brain function. These treatments show promise in slowing down cognitive decline in the early stages of Alzheimer’s; however, these medications do not improve symptoms or stop the disease, and the clinical effect is modest.

As of earlier this year, there are two treatments approved by the Food & Drug Administration (FDA), and they are available for people with Mild Cognitive Impairment (MCI) or early-stage AD. It’s important to understand that these treatments are not for everyone and have the potential for serious side effects, including brain swelling or bleeding. Speak to your healthcare provider to know if one is right for you or for a person you’re caring for.

Leqembi^® (generic name lecanemab) was the first of these treatments approved by the FDA in July 2023. It has been shown to slow the progression of AD in early-stage patients with MCI due to Alzheimer’s or mild Alzheimer’s disease. It works by clearing amyloid plaques from the brain. Leqembi is given by intravenous (IV) infusion, meaning a person goes to a doctor’s office or infusion center every other week to receive the treatment for at least 18 months. In July at the Alzheimer’s Association International Conference (AAIC), it was reported that people who stayed on Leqembi for three years without stopping continued to benefit from the treatment both cognitively and functionally. At Clinical Trials on Alzheimer’s Disease (CTAD) in October, Eisai, the company that makes Leqembi, shared that they are now studying its continued use on an ongoing once a month dose to see if that will maintain the effects of the treatment longer.

Kisunla^® (generic name donanemab) received FDA approval in July of this year, making it the second drug of this type to become available for people with MCI or early-stage AD. It also clears amyloid plaques from the brain and is given once a month through IV infusion. One notable difference is that people who receive Kisunla may be able to stop taking it once the amyloid is cleared from the brain which would be confirmed on a PET scan. Kisunla also carries risks for swelling or bleeding in the brain; however, Eli Lilly, the company that makes it, shared at CTAD in October the results of a new study that changed the dose given to patients for the first few infusions. By starting at a low dose for the first infusion and gradually increasing the dose over the next few infusions the risk for these serious side effects was significantly reduced. Eli Lilly has announced that they’re requesting that the FDA update the label, or the prescribing instructions. If or when the FDA approves this request, people beginning Kisunla going forward will receive the drug on this new schedule.

As mentioned above, Alzheimer’s Los Angeles is sharing this information for educational purposes only and not as an endorsement or recommendation of any specific treatment. Speak with your healthcare professional to find out if one of these treatments may be right for you or for the person you care for.

Researchers are also exploring combination therapies, which may use multiple drugs to target different aspects of Alzheimer’s. For example, combining amyloid-targeting drugs with tau-focused treatments or those that enhance brain cell communication may offer more effective outcomes than single treatments alone.

Recent studies have shown significant progress in targeting amyloid in Alzheimer’s disease through various methods. Lowering amyloid levels in the brain to very low levels has demonstrated clinical benefits. Suppressing tau proteins which cause tangles in the brain may also help reduce damage caused by amyloid, which may provide other ways to treat the disease at different stages.

Current data looks promising about the use of gene silencing, which is a process of shutting off the effect of a particular gene, to address Alzheimer’s disease. A drug from Biogen has been shown in clinical trials to lower tau protein levels in the brain. New ways to give a drug, like directly into the spine, are making these therapies more effective. Checkpoint inhibition, which aims to balance the immune system, is also showing promise in early trials.

There is growing recognition of the need for tailored approaches to Alzheimer’s treatment. Studying biomarkers in clinical trials and having data from using drugs in the real-world is critical for understanding how new drugs work beyond the controlled environment of clinical trials. Personalized strategies that take into account the unique biology and disease progression of each individual are essential for the best possible outcomes from treatment.

Novel Medications: As Alzheimer’s disease progresses, many patients experience behavioral and psychological symptoms, such as agitation, anxiety, and hallucinations. These common symptoms can be very distressing for family and friends and make it harder to keep the person living with Alzheimer’s safely at home. There is currently one drug, Rexulti^® (generic name brexpiprazole), specifically approved by the FDA to reduce agitation for people living with Alzheimer’s. This medication focuses on regulating brain chemicals like serotonin and dopamine, which play a key role in mood and behavior. If you’re caring for someone who has Alzheimer’s and is experiencing agitation, anxiety, or hallucinations, speak to their healthcare provider to see if this treatment might help them.

New medications are being tested to specifically target these symptoms. If you’re interested in exploring if a clinical trial may be right for you or a person you’re caring for, speak to your healthcare provider about your options.

Non-Pharmacological Interventions: It’s very important to understand that alongside drug treatments, there are non-drug approaches to managing agitation and psychosis. This includes personalized care plans that incorporate cognitive behavioral therapy (CBT), music therapy, and structured environments to reduce stress and agitation for people with Alzheimer’s. Early trials of these interventions are showing positive results, especially when used alongside medications.

Alzheimer’s LA offers workshops called IDEA! that help caregivers understand the cause of these troubling behaviors as well as learn how to manage them in the moment. We also offer a workshop on providing suggestions for how to effectively communicate with a person living with dementia, which can help both people feel better when things get hard.

Early Diagnosis through Blood Tests: One of the most promising advances in Alzheimer’s research is the development of blood-based biomarkers, which could enable earlier and more accurate diagnosis of the disease. In 2024, several blood tests have shown the ability to detect key proteins associated with Alzheimer’s, such as amyloid and tau, at very low levels in the bloodstream. These tests offer a less invasive and quicker alternative to brain scans and spinal fluid tests, which could give people the opportunity to be diagnosed and helped earlier.

Ahead 3-45 study: The AHEAD 3-45 study aims to remove amyloid at the earliest detectable stage of AD to slow progression and prevent cognitive decline. The study includes two trials: A3, focusing on individuals with intermediate amyloid, and A45, targeting those with elevated amyloid levels.

The study introduced a pre-screening blood test which improved the accuracy of the process to determine a person’s amyloid levels before having them get a PET scan. A specialized blood test, along with the p-tau217 ratio (a biomarker on the tau protein that is linked to Alzheimer’s and shows up in the blood when changes in the brain, like amyloid buildup, start to occur) helped improve the rate of screening success for the trial. This is the first time a blood test has been used in a clinical trial to determine a person’s amyloid levels. The study also found that higher p-tau217 levels in blood plasma were closely linked to increased amyloid and tau levels in the brain, even in the early stages of amyloid buildup.

Plasma testing was added as the first step in screening to improve diversity through customized outreach efforts to engage underrepresented racial and ethnic groups (REU RG). As a result, 27% of people screened in North America came from these groups. However, the final group of people actually enrolled in the study was less diverse. Despite this, all people who qualified for the study based on their plasma test had similar eligibility rates, regardless of their racial or ethnic background.

The study shows that plasma biomarkers like p-tau 217 are helpful for identifying people who may be able to successfully enroll in trials that test anti-amyloid therapies at early stages of AD. These biomarkers can help predict amyloid buildup, and the study stresses the need for inclusive clinical trials. It also points out that factors like vascular health, inflammation, and social conditions might explain the higher dementia risk in underrepresented groups, even though they tend to have lower amyloid levels.

Tracking Disease Progression: Blood tests are also being developed to monitor the progression of AD over time. These tests could help doctors assess the effectiveness of treatments and track how the disease is changing, allowing for more personalized treatment plans.

The New IDEAS study aimed to address disparities in Alzheimer’s diagnosis by recruiting a more diverse group of people, with a focus on African American and Latino people. The study uses amyloid-PET scans to see if they can help doctors diagnose and manage treatment for AD. Recruitment for the study was led by field experts using advanced methods to ensure diversity among people with MCI or dementia who are on Medicare. Participants underwent PET scans that were reviewed by local imaging specialists. People enrolled in the study provided their own self-identified race and ethnicity which were used to categorize them, and data collection also included information on social determinants of health including other medical conditions, disease stage, and cognitive assessments. The study included an impressive 40% of participants from underrepresented groups.

Analysis of data from the study revealed significant disparities among participants. Black and Latino people were more likely to have lower education levels, to live alone or in disadvantaged areas, and to use Medicare Advantage plans (often used by lower-income people). These participants also had higher rates of vascular risk factors like hypertension (high blood pressure), unusual clinical features, and were often diagnosed at more advanced stages of dementia. Interestingly, these groups had lower amyloid PET results (61%) compared to non-Black Latinos (68%).

The findings from the New IDEAS study underscore significant disparities in social determinants of health, vascular risk factors, and amyloid PET levels across racial and ethnic groups. This points to the need for greater diversity in Alzheimer’s research and for clinical trials to address factors that can be modified, like lowering blood pressure through diet and exercise, and improving equitable care.

Research into AD is advancing rapidly and focusing on several key areas. Below are the main areas of current research, but there are other areas not listed here. We’re providing only very brief summaries of each area but will provide more educational explanations as advances in any area comes forward. Here are the key areas of study at the moment:

Amyloid and Tau Proteins

• Amyloid-beta targeting: Work continues on therapies that aim to reduce amyloid plaques in the brain. Recent advances include monoclonal antibodies, like Leqembi and Kisunla, that show promise in slowing cognitive decline by clearing amyloid deposits.
• Tau-based treatments: Efforts focus on preventing tau protein tangles, another hallmark of AD. These include drugs that prevent tau from clumping in the brain and vaccines to reduce tau buildup.

Neuroinflammation

• Microglial modulation: Research explores how immune cells in the brain called microglia contribute to AD. Therapies aim to regulate overactive immune responses that make damage to neurons worse.
• Anti-inflammatory drugs: Studies investigate medications that target inflammation pathways to prevent or slow disease progression.

Synaptic Health and Neuroprotection

• Neuroprotective agents: These drugs aim to safeguard neurons and the connections between synapses from failing.
• Synaptic repair: Efforts include increasing brain plasticity, or the brain’s ability to restructure itself over a lifetime and repairing damaged synapses to improve cognition and memory.

Lifestyle and Multidomain Interventions

• Studies investigate how lifestyle changes (diet, exercise, cognitive training) might prevent or delay AD onset.
• Clinical trials like FINGER (eg, US POINTER study) focus on combined lifestyle interventions for at-risk populations.

Genetic Therapies

• Gene editing and modulation: Research explores targeting specific genetic risk factors (eg, APOE4) using technologies like CRISPR.
• Familial AD studies: Trials focus on young-onset genetic forms of AD to understand mechanisms and to develop tailored treatments.

Biomarkers and Early Detection

• Fluid biomarkers: Studies focus on blood and cerebrospinal fluid (CSF) markers for early detection of amyloid, tau, and neurodegeneration.
• Neuroimaging advancements: PET and MRI scans are used to see changes in the brain caused by AD and to monitor responses to treatments.

Vascular Contributions

• Cerebrovascular health: Research examines how reduced blood flow and small vessel disease in the brain contribute to AD, leading to therapies that target vascular dysfunction.

Gut-Brain Axis

• Investigations focus on how the microbiome in our gut influences brain health, with potential interventions including probiotics or dietary modifications.

Emerging Areas

• Cell-based therapies: Using stem cells to replace damaged neurons.
• RNA-based therapeutics: Exploring mRNA and siRNA to regulate gene expression.
• Epigenetic interventions: Targeting changes in gene regulation linked to AD.

The landscape of Alzheimer’s research at the beginning of 2025 is full of hope, with new treatments aiming to slow or eventually stop the progression of Alzheimer’s, especially in its early stages. Progress in managing symptoms like agitation and psychosis offers better quality of life for people living with the disease and for their families and friends, while the development of blood-based biomarkers promises a simpler and faster way to diagnose and monitor Alzheimer’s. While many of these treatments and tools are still in the testing phase, the ongoing advancements suggest that we may be on the brink of major breakthroughs in the fight against Alzheimer’s disease.

*Nothing in this research summary is intended to provide recommendations for medical care. To understand your options, be sure to speak to your own healthcare provider.

To explore what clinical trials may be available in your area, please visit the Alzheimer’s & Dementia Research page on our website and scroll down to the Find a Clinical Trial tool, where you can enter your personal information. As always, speak to your healthcare provider to determine if any trial may be right for you.

**If you are interested in learning more about IDEA!, our other educational workshops, or speaking to a care counselor, please call the Alzheimer’s LA Helpline: 844-435-7259 or info@alzla.org

Support for the creation and dissemination of this report was provided by Eli Lilly & Company