NEUROPROTECTIVE TECHNIQUES FOR ALZHEIMER'S DISEASE: AN EXTENSIVE NARRATIVE ANALYSIS OF MECHANISMS AND FUTURE TREATMENT DIRECTIONS

Abstract

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by amyloid-β (Aβ) plaques, hyperphosphorylated tau, oxidative stress, mitochondrial dysfunction, synaptic degeneration, neurovascular dysregulation, and chronic neuroinflammation. Neuroprotection aims to preserve neuronal structure and function by intervening in convergent pathological pathways. Aims: To summarize mechanistic evidence for neuroprotective strategies relevant to AD, including antioxidant, mitochondrial, cholinergic, neuropeptide, glial, cannabinoid, hormonal, metabolic, and Aβ-directed approaches. Methodology: A systematic narrative review of literature published from January 1995 to March 2024 was described in the source manuscript. Web of Science, PubMed, and Scopus were searched, and studies were considered according to model validity, mechanistic clarity, translational relevance, and reproducibility. Results: Thirty-four core mechanistic reviews and studies were compiled. Reported mechanisms included attenuation of reactive oxygen species, SIRT1 activation, TREM2 modulation, nitric oxide regulation, mitochondrial stabilization, Aβ clearance, reduction of tau phosphorylation, angiogenic support, and synaptic preservation. Conclusions: The reviewed literature supports a multimodal neuroprotection framework targeting oxidative stress, neuroinflammation, mitochondrial dysfunction, and metabolic abnormalities. Early, biomarker-guided and combination approaches are identified as areas for future investigation.