Alzheimer’s disease as a public health and clinical challenge: risk factors, biomarkers, and treatment strategies

Introduction and purpose: Alzheimer’s disease (AD) is the most common cause of dementia and a growing clinical and public health challenge in ageing populations. Its rising prevalence, high social and economic burden, and lack of curative therapy highlight the need for better understanding of its mechanisms, risk factors, diagnostic tools, and treatment strategies. This review summarizes current knowledge on AD, with particular emphasis on biomarkers, modifiable risk factors, and emerging therapeutic approaches. Brief description of the state of knowledge: AD is characterized by extracellular amyloid-β deposition and intracellular accumulation of hyperphosphorylated tau; however, its pathogenesis is multifactorial and also involves neuroinflammation, gliosis, mitochondrial dysfunction, neuronal loss, demyelination, and genetic susceptibility. Age is the strongest risk factor, while low educational attainment, physical inactivity, obesity, cardiovascular risk factors, depression, hearing loss, and social isolation may also increase disease risk. Biomarkers, including amyloid PET, tau PET, cerebrospinal fluid analytes, and blood-based markers such as phosphorylated tau, neurofilament light chain, and glial fibrillary acidic protein, improve early and accurate diagnosis. Current treatment is mainly symptomatic, but anti-amyloid, anti-tau, immunological, and non-pharmacological strategies are under intensive investigation. Summary: Alzheimer’s disease should be viewed as both a neurodegenerative disorder and a public health challenge requiring prevention, early diagnosis, risk reduction, and personalized management. Further advances in biomarkers and targeted therapies may improve diagnostic precision and support more effective care.