Exploring the Multiple Pathogenic Mechanisms, Clinical Manifestations, Diagnostic and Therapeutic Dilemmas, and Research Frontiers of Alzheimer's Disease

Abstract

With the rapid growth of the global aging population, the incidence of Alzheimer's disease (AD) has been increasing year by year. This progressive, irreversible and insidious neurodegenerative disease will lead to progressive cognitive deterioration, posing a major public health threat to seniors and bringing heavy burdens to families and society. However, its complex and multi-dimensional pathogenesis has not been fully clarified, and major bottlenecks still exist in early screening, accurate diagnosis, and radical treatment. This paper systematically reviews the progression of AD, categorizing it into three stages: the subjective cognitive decline, mild cognitive impairment and AD dementia and describes its progression from early latent symptoms to severe functional impairment in middle and late stages. Based on this, this article deeply analyzes the multiple and interrelated pathogenic mechanisms of AD from four dimensions: canonical amyloid-tau proteinopathy, cerebral metabolic dysfunction, cerebral white matter structural impairment and systemic inducing factors. The study summarizes current mainstream interventions, pointing out key dilemmas including delayed diagnosis, single-target therapeutic limitations, and comorbidity interference, and lack of curative drugs. Additionally, this paper reviews cutting-edge research fields: diabetes-associated pathological pathways, DTI imaging, AI-assisted diagnosis, gut-brain axis regulation, and new targeted treatments. The study shows that AD is a complex disease driven by multiple factors, systems and mechanisms, and a single intervention is difficult to overcome the current predicament. This paper offers a comprehensive theoretical reference for AD early warning, pathological mechanism research, precision diagnosis and treatment, and translational medical development.