This review examines repetitive transcranial magnetic stimulation (rTMS) as a potential adjunctive approach for Alzheimer’s disease (AD), focusing on how it may affect AD-related pathology, synaptic plasticity, and neural rehabilitation. The authors describe evidence from animal and clinical studies suggesting that rTMS may influence amyloid-β generation and clearance, glial cell activation, neuroinflammation, apoptosis, gene expression, neurotrophic factors, and microRNA pathways. They also note that rTMS may help regulate synaptic structure and function by affecting dendritic spine formation, long-term potentiation, cortical excitability, and the balance between excitatory and inhibitory neural networks.

The review also highlights clinical research suggesting that rTMS targeting regions such as the dorsolateral prefrontal cortex or precuneus may support cognitive function or slow decline in some patients with AD or mild cognitive impairment (MCI). However, results vary based on stimulation target, frequency, intensity, duration, and individual patient factors. The authors emphasize that many findings remain preliminary, especially regarding long-term effects, optimal protocols, and patient-specific targeting. They conclude that rTMS is a noninvasive and potentially useful tool for AD rehabilitation or distinguishing AD from MCI. However, more standardized, personalized, and mechanistically focused studies are needed before broader clinical use.

Reference: Ji Y, Yang C, Pang X, et al. Repetitive transcranial magnetic stimulation in Alzheimer’s disease: effects on neural and synaptic rehabilitation. Neural Regen Res. 2025 Feb;20(2):326-342. doi: 10.4103/NRR.NRR-D-23-01201. PMID: 38819037; PMCID: PMC11317939.

This randomized controlled trial evaluated whether a 20-week intensive multimodal lifestyle intervention could affect cognition and function in adults with mild cognitive impairment (MCI) or early dementia due to Alzheimer’s disease. The intervention included a whole-food, minimally processed plant-based diet with supplements, moderate exercise, stress management, and support groups. Fifty-one participants were randomized to the lifestyle intervention or usual care; 49 completed the 20-week assessment. Compared with the control group, the intervention group showed statistically significant differences in several standard cognition and function measures, including CGIC, CDR-SB, and CDR-Global, with borderline significance on ADAS-Cog in the primary analysis. In sensitivity analyses excluding one outlier, all four measures showed significant differences favoring the intervention.

The study also found favorable changes in several biomarkers, including an increase in plasma Aβ42/40 ratio in the intervention group and a decrease in the control group, along with improvements in insulin, LDL cholesterol, ketones, and glycoprotein acetylation. Greater adherence to the lifestyle intervention was associated with greater improvements in cognition, function, and several biomarkers, suggesting a possible dose-response relationship. The authors note important limitations, including the small sample size, short duration, limited diversity, and inability to blind participants to lifestyle changes. They conclude that larger, longer, more diverse studies are needed to confirm whether intensive lifestyle modification can meaningfully affect the course of MCI or early dementia due to Alzheimer’s disease.

Reference: Ornish D, Madison C, Kivipelto M, et al. Effects of intensive lifestyle changes on the progression of mild cognitive impairment or early dementia due to Alzheimer's disease: a randomized, controlled clinical trial. Alzheimers Res Ther. 2024 Jun 7;16(1):122. doi: 10.1186/s13195-024-01482-z. PMID: 38849944; PMCID: PMC11157928.

This systematic review and meta-analysis evaluated the global prevalence of mild cognitive impairment (MCI) in older adults and factors associated with its occurrence. The authors included 51 high-quality studies involving 287,689 geriatric participants. Using a random-effects model because of high heterogeneity, they estimated the global prevalence of MCI in the geriatric population at 23.7%. Prevalence varied widely across studies and regions, with higher estimates reported in some African and Asian cohorts. Meta-regression also suggested that reported MCI prevalence has increased over time, while larger sample sizes were associated with lower prevalence estimates.

The review identified several factors associated with MCI in older adults, including older age, lower educational level, depression, low socioeconomic status, stroke, high blood pressure, low physical activity, and female sex. The authors note that differences in diagnostic tools, cutoffs, study methods, and population characteristics likely contributed to the wide variation in prevalence estimates. Because MCI can progress to Alzheimer’s disease or other dementias-but also may remain stable or improve-the authors emphasize the importance of awareness, caregiver education, periodic cognitive assessment, and preventive strategies focused on modifiable risk factors.

Reference: Salari N, Lotfi F, Abdolmaleki A, et al. The global prevalence of mild cognitive impairment in geriatric population with emphasis on influential factors: a systematic review and meta-analysis. BMC Geriatr. 2025 May 6;25:313. doi: 10.1186/s12877-025-05967-w.