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

Dementia is a syndrome that can be caused by a number of diseases and damage to nerve cells, and affects brain function over time, leading to a decline in cognitive ability. Alzheimer’s disease (AD) is the most common type of dementia (accounting for 60%–70% of all cases), serves as a hallmark neurodegenerative disorder; it is characterized by the insidious onset of cognitive impairment–specifically affecting memory, judgment, and problem-solving (). It is characterized by the extracellular accumulation of plaques containing β-amyloid (Aβ) and the intracellular formation of tangles of tau protein-containing neuroproteins fibers (). Pathologically, it initially manifests as synaptic dysfunction, progressing to neurodegeneration and neuronal cell death in later stages (). The most recent data indicate that the epidemiology of AD and general dementia are closely related (). The latest data from the World Health Organization (WHO) shows that, approximately 55 million people are currently living with dementia worldwide, with almost 10 million new cases arising annually (). Given its prevalence and aging global population, it is becoming a global health problem, with individual and societal implications. Furthermore, AD patients primarily present as progressive cognitive impairment and behavioral deficits, negatively impacting the health and quality of life of older individuals. These symptoms also place a financial burden on families and society (; ). Currently, drug interventions for AD focus primarily on symptom management (Mertas and Bosgelmez, 2025). Consequently, there is an imperative for the development of novel, effective and safe non-pharmaceutical interventions (NPIs) that can intervene and treat AD. NPIs have been demonstrated to be both cost-effective and devoid of adverse reactions, whilst concomitantly exerting a favorable influence on the quality of life of patients afflicted with cognitive impairment and their caregivers (). The objective of this study is to proposes an integrated therapeutic framework to elucidate the synergistic effects of physical activity, dietary therapy, and CST, thereby providing a structured, evidence-based approach to optimize outcomes in neurodegenerative management. A systematic review and meta-analysis showed that multi-domain lifestyle interventions (combining physical exercise and cognitive training) can effectively modulate the overall cognitive abilities of older adults with normal cognitive function (). In addition, recent scoping evidence underscores the superior efficacy of multidomain interventions over single-modality approaches, providing a foundational basis for the shift toward integrative, patient-centered AD management (). A systematic review () synthesizing evidence on the integration of lifestyle and pharmacological/nutraceutical interventions, provides a compelling framework for precision prevention across the AD continuum, highlighting the synergistic potential of combining multi-target strategies. The complex pathophysiological mechanisms and heterogeneity of AD have long limited the efficacy of clinical interventions. While previous reviews have largely focused on specific pathological pathways or traditional drug therapies, there has been little systematic analysis of existing non-pharmacological approaches. By systematically integrating existing clinical evidence on non-pharmacological interventions, this article provides clinicians with actionable intervention strategies and offers prospective theoretical support for transforming AD research toward “prevention and personalized management.”