Neurodegeneration and Precision Medicine: Innovative Approaches in Alzheimer’s Disease Therapy

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Abstract
Alzheimer’s disease (AD) represents one of the most complex neurodegenerative disorders, demanding a transition from symptom-based management toward biologically informed, patient-centered precision medicine. This review analyzes recent advances in molecular biomarkers, proteomic profiling, and monoclonal antibody therapies, integrating global evidence and expert consensus from Mexico, Colombia, and Ecuador. A systematic analysis of 24 high-impact studies published between 2018 and 2025 demonstrated that plasma and CSF biomarkers—especially p-tau217, p-tau181, and proteomic signatures—provide exceptional accuracy for early diagnosis and disease staging, surpassing traditional clinical criteria. Evidence from phase 3 trials with lecanemab and donanemab confirmed that amyloid-targeted therapies can significantly slow cognitive and functional decline when guided by validated biomarkers. Complementary Delphi consensus findings revealed strong expert agreement on adopting p-tau217 as a first-line test, incorporating APOE genotyping and MRI safety monitoring, and ensuring ethical and equitable implementation of precision medicine in Latin America. This review concludes that Alzheimer’s research is undergoing a paradigm shift toward molecular definition, individualized therapy, and ethically responsible innovation. Future efforts should focus on expanding biomarker validation in diverse populations, integrating artificial intelligence for real-time monitoring, and reinforcing multidisciplinary education. Precision medicine thus represents not only a scientific advance but also an ethical and social commitment to global equity in dementia care.

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