Alzheimer's disease

Morbus Alzheimeri · Alzheimerova nemoc

What it is

Amyloid plaques and tau tangles kill neurons; memory goes first.

call 112 / 911 now Sudden confusion or drowsiness over hours — often an infection or stroke
call 112 / 911 now Face droop, one-sided weakness or new trouble speaking
see a doctor soon Getting lost, wandering at night or unsafe with the stove
see a doctor soon Stopping eating or drinking, or losing weight fast

Donepezil, rivastigmine, galantamine — a small symptomatic lift for some, no change to the course mixed evidence
Memantine — smaller still mixed evidence
Lecanemab and donanemab — about a quarter less decline on a scale, which is a fraction of a point in practice; brain swelling in about 1 in 8 on lecanemab and 1 in 4 on donanemab, micro-bleeds in more, a few fatal, and a price to match mixed evidence
Treating blood pressure, hearing loss and inactivity — the risk factors with the best evidence trials support

Anti-tau antibodies
Oral semaglutide — no slowing of decline in the EVOKE trials (2025) not confirmed in trials
focused ultrasound to open the blood-brain barrier
photobiomodulation
multidomain FINGER-style prevention

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

Souvenaid (a medical food) — the LipiDiDiet trial slowed decline on secondary measures mixed evidence
40 Hz light and sound stimulation — early trials early / small studies
Lion's mane mushroom — a small trial in mild impairment early / small studies
Coconut oil and ketone drinks — small trials; no clear benefit early / small studies
The Bredesen protocol (ReCODE) — case series report improvement; no controlled trial anecdotal / traditional
Ginkgo biloba to prevent dementia — the large GEM trial found no effect not confirmed in trials