New developments in dementia therapy

Older couple with their dog on a walk

In dementia research, the primary aim is to ensure that those affected maintain their independence for as long as possible. © mykeyruna, GettyImages

The development of new therapies and drugs against Alzheimer's has been given high priority in research centers and pharmaceutical companies for years. The research focuses in particular on treatment with and without medication as well as on neurostimulation.

Treatment without medication

It is possible to treat Alzheimer's disease without medication. The aim of such therapies is to increase or maintain the quality of life and well-being of those affected. The goals of drug-free treatment include maintaining the greatest possible independence, promoting physical and mental abilities and reducing psychological problems such as depression or aggression.

In the Working with people with dementia Exercise therapy, sports or even artistic exercises are used. The focus is always on the personality of the sick person and their individual life situation. The form and stage of the disease also play a role.

Treatment with medication

There is still no drug that can completely cure dementia. Therefore, the main aim of drug treatment is to maintain and, if possible, improve mental capacities such as orientation and memory and to slow down the progression of the disease. Those affected should remain independent in their everyday lives for as long as possible. Alleviating psychological complaints is also one of the goals of therapy with medication. Various medications are used for Alzheimer's dementia. These include, among others, cholinesterase inhibitors and medications with the active ingredients gingko biloba, lecanemab and memantine.

Cholinesterase inhibitors

Cholinesterase inhibitors have the function of improving the exchange of information between neurons. Drugs in this group contain active ingredients such as donepezil, rivastigmine and galantamine. Allowed in Germany Cholinesterase inhibitors only be used for mild to moderate forms of dementia. With the help of these medications it is possible to delay mental decline somewhat. This occurs because the nerve cells in the brain that communicate via messenger substances are broken down more slowly. However, it should also be mentioned that 30 to 50 percent of those affected do not respond to cholinesterase inhibitors. Possible side effects may include dizziness, nausea and vomiting.


When neurons in the brain communicate, the messenger substance glutamate is released. This person is responsible for forwarding information. In many cases, there is an excess of glutamate in the brains of people with dementia. This causes permanent activity of the neurons, which subsequently do not rest sufficiently. This in turn leads to damage and ultimately death of the nerve cells. Memantine blocks the places where glutamate flows and thus causes the neurons to rest. Memantine has the ability to slow the decline of mental abilities in people with dementia. Possible side effects include headaches, fatigue, digestive problems and increased blood pressure.

Gingko biloba

Medicines that contain the active ingredient Gingko biloba are obtained from the leaves of the Ginkgo tree. These can be prescribed by a doctor, but are also available without a prescription. Since Gingko biloba can inhibit the effect of blood clotting agents, its use should always be discussed with a doctor.

The effects of Gingko biloba have not yet been fully researched. It is believed to contain substances that support blood flow to the brain, thereby improving patients' mental abilities. Gingko biloba is also said to provide possible relief from psychological complaints.


A new drug was recently approved in the USA that, according to the results of several studies, can delay the progression of dementia. It is a drug that contains the antibody lecanemab. This binds to precursors of a protein that has been detected between the neurons of dementia patients. The manufacturer also applied for approval for the EU in February 2023. In April 2023, another manufacturer reported positive results from a study with patients in the early stages of the disease. This involved the use of a drug with the similar active ingredient donamemab. Approval was also applied for for this.

Transcranial pulse stimulation (TPS)

Alzheimer's research is not only concerned with the development of new drugs. Recently, a neurostimulation procedure called transcranial pulse stimulation (TPS) has been making a name for itself. Many scientists see this as a significant step into the future of dementia therapy. This procedure was developed by Prof. Roland Beisteiner and then implemented with an international research consortium at the Neurological Faculty of the University of Vienna. In which TPS concept it is a novel rehabilitation therapy for various brain diseases.

This highly complex therapy uses neuroplastic reorganization, the application of which requires many years of experience in the field of neurology and neuroscience. The aim of TPS is to use physical stimulation of the corresponding areas of the brain to restore the cognitive and motor skills of those affected and to maintain them for as long as possible. The technique uses ultrasound pulses to (re)activate important brain regions, thereby supporting the reconstruction of lost capacities. This is done by introducing the pulses non-invasively via a transmitter located on the head. According to current knowledge, TPS is painless, well tolerated and does not require any additional medication support. However, safe use of the procedure requires special knowledge and proven scientific expertise in the area of ​​network analysis and brain function diagnostics.

TPS at a glance

Transcranial pulse stimulation is:

  • safe – it is carried out without opening the skull directly on the surface of the head while conscious and without pain; When used correctly, TPS is not only safe but also well tolerated.
  • effective – according to study results available so far, most patients respond to TPS; so there is a great demand for repetitions of the therapy.
  • demanding - the highly complex therapy requires extensive knowledge and many years of experience in order to correctly identify the corresponding brain areas and to be able to adjust them correctly on the device.
  • uncomplicated – a treatment takes around 30 minutes per session. Parts of the head must be rubbed with an ultrasound gel before therapy. However, shaving the hair on the head is not necessary.

Many researchers see transcranial pulse stimulation as a dementia treatment method with great potential for the future. Therapy is increasingly taking center stage at international neurological conferences. Doctors and scientists hope to be able to use TPS to better treat the ever-increasing number of patients with neurodegenerative diseases.

November 29, 2023

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