#399 ‒ The evolution of Alzheimer's disease and dementia care: how early detection, personalized treatment, new therapies, and a multimodal approach are changing the landscape | Gayatri Devi, M.D.

Dementia represents a spectrum of progressive neurological conditions rather than a binary diagnosis, requiring highly individualized, multimodal treatment strategies. Early detection through rigorous biomarker analysis—including amyloid, tau, and neuroinflammation markers—is critical for effective intervention, particularly in high-functioning patients who utilize cognitive reserve to mask symptoms. While anti-amyloid monoclonal antibodies like lecanumab offer potential to alter disease progression, they necessitate cautious, low-dose titration protocols to mitigate risks of amyloid-related imaging abnormalities, especially in APOE4 carriers. Beyond Alzheimer’s, managing vascular health and addressing menopause-related cognitive impairment through hormone replacement or targeted neurostimulation are essential components of brain health. Neurologist Dr. Gaya Devi emphasizes that shifting from a reductionist staging model to domain-specific functional assessment allows for more precise, personalized care that can stabilize or even improve cognitive outcomes in patients previously considered to have irreversible decline.