​​Alzheimer’s disease today: emerging therapies, scientific uncertainties, and the role of body-based interventions

With regard to Alzheimer’s disease, despite decades of intensive research, effective curative therapies are still lacking. Recent pharmacological developments have introduced treatments capable of modestly slowing disease progression in selected patients at early clinical stages, but none are able to halt or reverse the neurodegenerative process. At the same time, Alzheimer’s disease remains a condition that is only partially understood, both in terms of its biological markers and its etiology.

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The pathological hallmarks most commonly associated with Alzheimer’s disease—amyloid-β plaques and tau neurofibrillary tangles—are central to current diagnostic and research models and can now be detected through increasingly refined biomarkers, including blood-based assays. Nevertheless, contemporary research acknowledges that these markers do not fully explain the heterogeneity of clinical presentations, disease trajectories, or individual vulnerability. Alzheimer’s disease is increasingly understood as a multifactorial and systemic condition, shaped by interactions between genetic susceptibility, aging processes, vascular and metabolic health, lifestyle, and environmental factors.

 

New therapeutic developments and their limits

Recently approved monoclonal antibodies targeting amyloid pathology have marked an important milestone, as they demonstrate, for the first time, a statistically significant slowing of cognitive decline in some individuals with early-stage Alzheimer’s disease. However, these benefits are generally modest, apply only to narrowly defined patient populations, and are accompanied by relevant risks and monitoring requirements, such as amyloid-related imaging abnormalities (ARIA). Consequently, the scientific and clinical communities continue to debate their real-world impact and long-term cost–benefit balance.

 

Scientific uncertainties and ongoing debates

Despite advances in biomarker research, the etiology of Alzheimer’s disease remains contested. The long-dominant amyloid cascade hypothesis is now widely regarded as necessary but insufficient to account for the complexity of the disease. Increasing attention is being paid to the role of inflammation, vascular dysfunction, metabolic factors, psychosocial stress, and life-course exposures. Within this context, international consensus reports emphasize that a substantial proportion of dementia cases may be prevented or delayed through interventions targeting modifiable risk factors, including physical inactivity, social isolation, cardiovascular risk, and sensory impairment.

 

Tai Chi as a complementary body-based practice in Alzheimer’s disease

Within this landscape of partial therapeutic progress and persistent uncertainty, growing attention has been directed toward non-pharmacological and integrative interventions. Among these, Tai Chi (Tai Ji Quan) has gained increasing recognition within mainstream medical and gerontological research as a safe, adaptable, and low-impact mind–body practice, particularly suited to older adults and individuals with cognitive vulnerability.

 

Scientifically documented benefits

Although Tai Chi is not proposed as a cure for Alzheimer’s disease, a growing body of scientific literature supports its potential role in supporting cognitive, motor, and functional domains, especially in individuals with early-stage dementia or mild cognitive impairment (MCI)—a condition often considered prodromal to Alzheimer’s disease.

 

Cognitive function
Systematic reviews and controlled studies indicate that Tai Chi practice may contribute to improvements in global cognitive function in individuals with early dementia, particularly over short- to medium-term interventions. In populations with MCI, meta-analyses report positive effects on standardized cognitive measures, including global cognition and selected domains such as attention and executive function. Notably, randomized controlled trials of cognitively enriched Tai Chi—integrating attentional and executive challenges into movement sequences—have demonstrated superior outcomes compared with standard Tai Chi or stretching programs.

 

Balance, mobility, and functional capacity
Research examining Tai Chi in people with dementia highlights its feasibility and safety, especially when programs are adapted and, where appropriate, delivered in patient–caregiver dyads. While results on balance and fall prevention are mixed, these studies provide valuable insights into how structured movement practices can be realistically implemented in cognitively impaired populations.

 

Adherence and psychosocial dimensions
Studies focusing on participation and adherence emphasize that Tai Chi can be well accepted when appropriately tailored, with reported benefits extending beyond physical outcomes to include engagement, motivation, and perceived well-being. These aspects are particularly relevant in chronic neurodegenerative conditions, where quality of life and daily functioning are central therapeutic goals.

 

A medical anthropology perspective

For over thirty years, medical anthropology has contributed to broadening biomedical perspectives by highlighting the cultural, relational, and experiential dimensions of health and illness. From this standpoint, medicine is not only a technical enterprise but also a system of meanings, practices, and embodied experiences. Within such a framework, Tai Chi is not viewed as an “alternative” therapy, but rather as an integrative practice that addresses the person as a whole—body, attention, movement, and relationship with the environment.

In the context of Alzheimer’s disease, this perspective underscores the value of interventions that do not merely target isolated biological mechanisms, but instead support embodied regulation, continuity of agency, and meaningful engagement in everyday life.