The prevalence of Alzheimer's disease stands at more than 55 million individuals in the world, with estimates showing that the figure will increase to 152 million in 2050. Existing treatment methods are mostly symptomatic and do not address the underlying molecular disruptions, such as oxidative stress, mitochondrial dysfunction, and neuroinflammation. Neurodegeneration mediated by convergent pathways of these processes occurs through Aβ and hyperphosphorylated Tau. This is an overall review summarizing evidence from the PubMed, Scopus, and Web of Science databases as of 2025 on phytochemicals that can address both amyloid and tau pathologies simultaneously. This study presents a comprehensive assessment of more than 100 bioactive compounds across 7 chemical families with dual anti-amyloid and anti-tau effects, without prior reviews that address separate pathological targets or isolated classes of compounds with bioactivity. Major phytochemicals, such as curcumin, resveratrol, and epigallocatechin-3- gallate, suppress the activity of the beta-secretase, prevent the formation of amyloid fibrils, inhibit glycogen synthase kinase-3beta-mediated tau phosphorylation, and promote autophagy-lysosomal clearance. These molecules regulate NF-erythroid-2-related factor 2 signaling to inhibit reactive oxygen species and inhibit NF-κB-mediated neuroinflammation. Preclinical models show reductions in cognitive and neuropathological burden, but bioavailability and blood-brain barrier penetration pose barriers to clinical translation. Developed nanotechnology-based systems of delivery and structural modifications have potential in overcoming pharmacokinetic constraints. This represents a multi-target candidate therapy, a paradigm shift from the single-pathway therapeutics of the past, which may provide disease-modifying strategies beyond symptom management of Alzheimer's disease.
Ahmed et al. (Mon,) studied this question.