Alzheimer’s disease is a long-term, neurodegenerative disease of the brain,
which is a major cause of dementia affecting the elderly population. It is also
characterised by behavioural dysfunction and cognitive impairment. Alzheimer’s
disease is a complex disease involving multiple genetic and environmental risk factors.
Despite significant advancements in the study of Alzheimer's disease, many aspects of
the disease are still poorly understood. Although a reduction in acetylcholine and the
formation of amyloid-beta plaques are characteristic signs of Alzheimer's disease, the
precise causes and mechanisms underlying the illness are still unknown. Significant
reduction of neurotransmitters, such as acetylcholine and butyrylcholine, and
aggregation of β-amyloid protein in the neocortex of the brain are strongly linked to the
etiology of Alzheimer's disease. Although there is currently no treatment for
Alzheimer's, both pharmaceutical and non-pharmacological therapy options are being
thoroughly studied. Recent research has introduced promising new drugs designed to
address the root causes of AD. Acetylcholinesterase inhibitors (e.g., donepezil) and
NMDA receptor antagonists (e.g., memantine) are used for symptomatic relief.
Donepezil was the first cholinesterase inhibitor drug approved for the symptomatic
treatment of Alzheimer’s disease. Later, other drugs, such as rivastigmine and
galantamine, also got FDA approval. Newly FDA-approved drugs, such as
Aducanumab and Lecanemab, have been effective in reducing amyloid plaques. Many
hybrid molecules targeting two or more relevant sites of disease have been developed
and tested. These hybrid compounds showed antiinflammatory and amyloid
aggregation inhibition. Additionally, many global clinical trials are underway testing
effective therapies for Alzheimer’s disease. Current therapies can control symptoms,
but they cannot halt or reverse the disease's course. Researchers are now focusing on
target the molecular mechanisms that underlie Alzheimer’s disease. This chapter
examines the most recent therapeutic approaches targeted at amyloid plaques, tau
protein tangles, neurotransmitter imbalances, anneuro inflammation.
Keywords: Acetylcholine, Alzheimer’s, β-amyloid, Dementia, Donepezil, FDA, Galantamine, NMDA, Rivastigmine.
