Advancements in non-pharmaceutical interventions for Alzheimer’s disease management: an update review

Abstract

Alzheimer’s disease (AD) is a chronic, progressive neurodegenerative condition that is characterized by an increasing incidence rate due to global population aging, resulting in a significant social and economic burden. Current pharmacological interventions offer only limited relief and are unable to halt neuronal loss and cognitive decline. Therefore, safe and effective non-pharmacological interventions (NPIs) are needed for the management of AD. This review systematically synthesizes literature from the PubMed and Web of Science databases (2020–2025) to evaluate the comparative efficacy of physical activity, dietary interventions, and cognitive stimulation therapy (CST), aiming to establish an evidence-based framework for optimized clinical implementation. Specifically, physical activity (e.g. aerobic exercise and strength training) has been shown to improve cognitive and physical function. Dietary interventions (e.g. the Mediterranean diet, Dietary Approaches to Stop Hypertension and The Mediterranean-DASH diet intervention for neurodegenerative delay diet) have been demonstrated to delay cognitive decline by modulating inflammation, but evidence regarding supplements is weak. Furthermore, CST has been evidenced to enhance patients’ cognitive abilities and quality of life. The present review not only summarizes existing literature on the subject, but also explores future research directions, including mechanisms and personalized approaches of these interventions to improve the prognosis of AD patients.