What Are the Latest Treatments for Alzheimer’s Disease?
A neurologist explains Alzheimer’s medications, at-home injections, who may qualify for treatment and promising research.
More than 7 million people in the United States are living with Alzheimer’s disease. For decades, medications primarily managed symptoms, but today, innovative treatments can target changes in the brain and slow the progression of early-stage Alzheimer’s.
The treatments, lecanemab and donanemab, target beta-amyloid, a protein that accumulates and forms plaques in the brains of people with Alzheimer’s disease.
"Lecanemab and donanemab are the first medications that reduce beta-amyloid levels and are clinically proven to slow Alzheimer’s progression, so impairment does not advance as quickly; however, they do not reverse the disease or restore memory that has already been lost,” says Dr. Lawrence Honig, a neurologist at NewYork-Presbyterian/Columbia University Irving Medical Center.
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In July 2026, Alzheimer’s treatment options expanded when the Food and Drug Administration (FDA) approved weekly, at-home lecanemab injections under the skin for patients beginning treatment. This new option can eliminate the need for regular visits to an infusion center.
“What has changed is that treatment for Alzheimer’s disease has become part of routine clinical care, rather than something people could only imagine,” says Dr. Honig. “We’re also looking at therapies designed to attack other aspects of the Alzheimer’s disease process, and we are hopeful for additional treatments in the coming years to build on the anti-amyloid medications.”
Health Matters spoke with Dr. Honig to understand how the treatments work.
What are the latest treatments for Alzheimer’s disease?
Treatment | How It's Given |
|---|---|
| Lecanemab | Intravenous infusion every two weeks or weekly injections under the skin |
| Donanemab | Intravenous infusion every four weeks requiring dose escalation, with different starting doses over the first few months |
Dr. Honig: The two FDA-approved medications are monoclonal antibodies, and they are designed to remove beta-amyloid from the brain and slow disease progression.
Clinical trials found that lecanemab slowed decline for people with early Alzheimer’s disease by about 26% to 37%. After 18 months of treatment, the mean beta-amyloid level in the brain by PET scan of most treated patients was below the threshold for amyloid positivity, meaning that a radiologist would not even know the patient had Alzheimer’s disease.
In donanemab’s phase 3 clinical trial, treatment with the drug was also associated with dramatic amyloid removal from the brain, as well as slowing of progression of the disease. In the full group of participants between 60 and 85 years with early Alzheimer’s, the trial found that donanemab treatment slowed decline in memory, thinking and functional measures by 20% to 29%.
What’s new about the at-home lecanemab injection?
Dr. Honig: One of the most significant recent advances is a new way to receive lecanemab in a subcutaneous formulation — an under-the-skin autoinjector.
Before this summer, patients beginning lecanemab always received IV infusions every two weeks, and an injectable formulation was available only for maintenance after completing 18 months of IV therapy.
Now, for eligible patients starting treatment, the approved weekly dose is delivered as two injections, usually in the thigh or abdomen, which can be done at home. After 18 months, patients may continue this regimen or move to a maintenance schedule of one injection per week.
The injectable form contains the same antibody, lecanemab, as in the intravenous form, and evidence has shown comparable amyloid reduction and side effects
At-home treatment does eliminate the need to travel to an infusion center, but patients will still need specialist oversight and regular MRI monitoring for possible brain side effects.
Who qualifies for lecanemab or donanemab?
Dr. Honig: The two medications are considered for people in the earliest symptomatic stages of Alzheimer’s disease with the following criteria:
- Mild cognitive impairment or mild dementia due to Alzheimer’s disease
- Evidence of beta-amyloid in the brain, generally proven through spinal fluid testing or amyloid PET scan
- MRI showing low risk of serious side effects
- Able to have MRI scans and follow the treatment schedule
- Consideration of genetic testing for the APOE4 gene, which can indicate personal risk of brain side effects of treatment
What are the risks and side effects?
Dr. Honig: The main risk associated with anti-amyloid antibodies is ARIA, which stands for amyloid-related imaging abnormalities. They can appear on an MRI as temporary brain swelling (ARIA-E) or as areas of brain bleeding (ARIA-H).
Most people with ARIA do not have symptoms, but regular MRI scans are needed to monitor for them.
What treatments are available for people who do not qualify?
Dr. Honig: People can still benefit from comprehensive Alzheimer’s care to manage symptoms.
Medications such as donepezil, galantamine, rivastigmine and memantine may provide benefits in memory and thinking. Other treatments can address sleep problems, mood symptoms, agitation, hallucinations, or other changes that may accompany dementia.
Everyone hopes that they can buy a special vitamin or supplement to help this disease, but that isn’t the case. No vitamin, supplement, special diet or over-the-counter product has been proved to improve or slow Alzheimer’s disease.
Patients should discuss supplements with a medical professional because some can cause side effects or interact with prescription medications.
What Alzheimer’s treatments are researchers studying next?
Dr. Honig: There are additional anti-amyloid therapies in development and also other therapies designed to address aspects of the Alzheimer’s disease process.
The most prominent, new developing therapies are those that target tau, another protein involved in Alzheimer’s.
Phase 2 clinical trial results for one drug, diranersen, were released this summer, demonstrating decreases in tau in the brain in people with early stages of the disease. This investigational treatment is delivered as an injection into the spinal fluid. Other anti-tau drugs include monoclonal antibodies, which are under investigation at Columbia University and worldwide.
New Tau Insights for Alzheimer’s Care
Researchers are learning more about tau, a protein that forms harmful tangles in the brain and is closely linked to memory decline in Alzheimer’s disease.
A clue to how tau tangles begin: Researchers at Columbia University have uncovered where tau is made in neurons and how this tau morphs into tangles, offering new insight into how the harmful tangles associated with Alzheimer’s may begin.
In the study, recently published in Nature Neuroscience, senior author Kapil Ramachandran, Ph.D. an assistant professor of neurological sciences at Columbia University Vagelos College of Physicians and Surgeons, and his colleagues used a new high-resolution imaging technique called STARFISH to pinpoint tau’s origins. They also found a pathway for how this tau morphs into the same structures seen in patients with Alzheimer’s, implicating a new biological process underlying the pathology of the disease.
A more precise way to predict Alzheimer’s symptom onset: A research team led by Dr. Richard Mayeux, neurologist-in-chief at NewYork-Presbyterian/Columbia University Medical Center, have identified a way to help predict when people at high risk of Alzheimer’s disease are likely to develop their first symptoms, a finding that could help physicians determine when to begin preventive interventions currently under development. The approach combines testing for elevated p-tau217 levels and the high-risk APOE4 gene.
When should someone see a doctor?
Dr. Honig: Occasionally forgetting a name or misplacing an item isn’t a red flag, but there are some signs that may warrant an evaluation, particularly when memory or changes in thinking are becoming more frequent or noticed by others:
- Repeating questions or conversations
- Struggling with words
- Difficulty completing familiar tasks
- Losing track of dates, seasons and time
- Changes that interfere with work or everyday activities
- A family history of dementia
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