WEDNESDAY, April 22, 2026 (HealthDay News) -- For patients with early Alzheimer disease and mild cognitive impairment, cognition is consistently improved with multimodal lifestyle interventions (MMLIs), while monoclonal antibodies (MABs) clear amyloid plaques but only modestly preserve cognition, according to research presented at the annual meeting of the American Academy of Neurology, held from April 18 to 22 in Chicago.
Majid Fotuhi, M.D., Ph.D., from the Mind/Brain Institute at Johns Hopkins University in Baltimore, and colleagues reviewed randomized controlled trials (RCTs) through July 2025 that included MMLIs or U.S. Food and Drug Administration-approved MAB therapies and reported Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) outcomes.
The researchers found that five RCTs of MMLIs reported ADAS-Cog improvements of 1.3 to 2.6 points, which indicated measurable cognitive gains. In some trials, benefits were sustained beyond intervention, and they were accompanied by improvements in executive function, mood, gait speed, quality of life, and biomarkers. MABs demonstrated preservation of 1.3 to 1.5 points on ADAS-Cog relative to placebo in three large phase 3 RCTs, reflecting a modest slowing of decline. Robust amyloid clearance was achieved by MABs, but they had limited clinical benefit. MABs demonstrated 27 to 32 percent preservation compared with benefit >200 percent with MMLIs.
"These lifestyle interventions appear more powerful than the drugs we studied," Fotuhi said in a statement. "Drugs that target amyloid are an important scientific advance, but these findings underscore that improving brain health requires a broader approach."