The State of Alzheimer Disease Care: An Update From Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP

Alzheimer disease (AD) research and treatment have advanced rapidly in recent years, with new disease-modifying therapies, updated diagnostic criteria, and emerging options for behavioral symptoms reshaping how clinicians approach both diagnosis and management. The US Food and Drug Administration (FDA) has approved 2 anti-amyloid antibodies, lecanemab and donanemab, for mild cognitive impairment due to AD and mild AD dementia, alongside blood-based biomarkers that offer a less invasive path to diagnosis. The National Institute on Aging and Alzheimer's Association also revised their diagnostic criteria for AD in 2024, and 2 new medications, brexpiprazole and a dextromethorphan-bupropion combination, have been approved for agitation associated with AD dementia.

Despite this progress, significant challenges remain, including persistent misinformation about the disease, a shortage of trained clinicians, and gaps in funding and policy support for prevention and treatment research.

To discuss where the field stands and where it is headed, Psychiatric Times sat down with Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP, professor and chairman of the Department of Psychiatry and the inaugural Bhatia Family Endowed Chair at Creighton University School of Medicine in Omaha, Nebraska, and adjunct professor of psychiatry at Yale School of Medicine.

Dr Tampi briefly explores the most significant recent advances in AD research, the treatment strategies and neuromodulation approaches on the horizon, and what clinicians can do now to improve outcomes for patients and families affected by the disease.

Psychiatric Times: What has been the most exciting recent update in Alzheimer disease research?

Rajesh R. Tampi, MD, MS, DFAPA, DFAAGP: The 2 new medications (lecanemab and donanemab) for the treatment of MCI due to AD and mild AD dementia; FDA approved blood biomarkers for the diagnosis of AD; the revised 2024 NIA-AA criteria for the diagnosis of AD; and 2 new medications (brexpiprazole and dextromethorphan-bupropion combination) for the treatment of agitation in AD dementia.

PT: What future directions do you envision for Alzheimer’s treatment?

Tampi: Newer medication classes with oral or subcutaneous method of taking the mediactions; neuromodulation strategies for treatment; and focus on prevention strategies.

PT: What challenges still stand out?

Tampi: There is still a lot of myth and misinformation about AD; availability of trained workforce is a huge challenge; we need better legislation and financial availability to study prevention and treatment of AD

PT: What can clinicians be doing to improve patient outcomes?

Tampi: Clinicians should learn to collaborate on the evaluation and management of AD; use of approved diagnostic criteria and guidelines for the assessment and management; and grassroots policy initiatives to educate lawmakers/policy makers about this serious condition.

PT: Any final thoughts?

Tampi: There is no quick and easy fix for the diagnosis and management of AD. We all have to collaborate and function at the top our skillset to have better outcomes for individuals with AD and their families.

Dr Tampi is a professor and chair of the Department of Psychiatry at Creighton University School of Medicine and Catholic Health Initiatives Health Behavioral Health Services. He is also an adjunct professor of psychiatry at Yale School of Medicine in New Haven, Connecticut, and a member of the Psychiatric Times editorial board.