After two decades of failed trials, the field finally has approved drugs that slow Alzheimer's — lecanemab and donanemab, which clear amyloid plaques from the brain. The benefit is modest and the drugs carry risks, but research is now intense, with hundreds of trials testing better and earlier treatments.
What's actually going on in research
Studies are testing next-generation amyloid-clearing antibodies, drugs that target tau tangles, anti-inflammatory approaches, and treatments aimed at people with very early or even pre-symptomatic disease. Researchers are also evaluating blood tests for earlier diagnosis, lifestyle programs to reduce risk, and treatments for behavioral symptoms like agitation.
Earlier treatment
Approved amyloid-clearing drugs slow disease most when given early. Trials are testing them in people with mild memory problems and even those with no symptoms but high risk.
Tau-targeted drugs
Tau tangles correlate more closely with symptoms than amyloid does. New antibodies and other drugs aimed at tau are entering late-stage trials.
Blood tests
New blood tests can detect amyloid and tau changes years before symptoms appear. They are being studied to guide who should be treated and to make trials faster.
What to know before you search
Eligibility often depends on stage (mild cognitive impairment, mild dementia, moderate), confirmed amyloid in the brain, age, and other health conditions.
What types of trials are currently open
- Treatment trials — Testing new drugs in people with Alzheimer's to see if they slow memory loss and other symptoms.
- Prevention trials — Testing drugs and lifestyle programs in people at high risk to prevent or delay Alzheimer's.
- Lifestyle and behavior trials — Testing exercise, diet, sleep, and cognitive training programs designed to support brain health.
- Device trials — Studies of brain stimulation, light therapy, and other devices aimed at slowing or treating Alzheimer's.
- Observational studies — Following people over time to understand how Alzheimer's develops, including blood and imaging biomarkers.
Recently added Alzheimer's Disease trials
Community-based Screening for Alzheimer's Disease
The goal of this prospective, multicenter, observational cohort study is to evaluate the screening performance of blood-based biomarkers for Alzheimer's disease (AD) in a real-world community screening setting, and to establish the population baseline levels and reference intervals of these biomarkers in Chinese older adults. The main questions it aims to answer is: What is the clinical screening value of blood biomarkers (phosphorylated tau 217 to amyloid β 42 ratio \[pTau217/Aβ42\] and glial fibrillary acidic protein \[GFAP\]) for AD among community-dwelling older adults? Eligible study participants will be randomly enrolled from community-dwelling older adults undergoing routine physical examinations and outpatient clinic attendees. All enrolled participants will undergo AD screening via blood biomarker testing. Participants with positive blood biomarker results (defined as abnormal pTau217/Aβ42 ratio and/or GFAP levels) will further complete a full battery of cognitive scale assessments, including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL) scale, and 17-item Hamilton Depression Rating Scale (HAMD-17). In addition, 15% of participants with negative blood biomarker results, selected via random sampling, will also complete the same cognitive scale assessments.
Retinal Hyperspectral Imaging in Neurodegenerative Diseases
Hyperspectral retinal imaging is a non-invasive imaging modality in which a series of images of the retina are captured using light of different wavelengths. The resulting "hypercube" of data provides a wealth of information about the retinal structure. Our group has developed evidence supporting a role for this technology in the detection of retinal amyloid beta in Alzheimer's disease. We are undertaking further studies to establish the role of this method in the assessment of people with dementia, or those at risk of Alzheimer's disease. In addition, we wish to test whether the approach may have value in other forms of dementia or neurodegenerative disease such as Parkinson's disease, Lewy-Body dementia or vascular dementia.
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