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The end of Alzheimer’s?
Peter Attia MD • • health
Key Points:
- Recent advances in Alzheimer's treatment have introduced donanemab (Kinsula®) and lecanemab (Leqembi®), monoclonal antibodies that clear beta-amyloid from the brain and slow cognitive decline for the first time.
- Although these therapies slow disease progression, their effects are modest, likely because patients in trials already had significant neurodegeneration and cognitive impairment at enrollment.
- Alzheimer's pathology involves beta-amyloid accumulation triggering tau protein spread and dysfunction of brain support cells, which together drive cognitive decline according to the amyloid cascade model.
- Evidence from Phase III trials supports this model, suggesting that earlier intervention—before extensive tau spread and brain cell damage—could more effectively delay or prevent Alzheimer's dementia.
- Pharmaceutical companies are now pursuing trials targeting early beta-amyloid clearance to potentially postpone or prevent the onset of Alzheimer's disease.
