Four Key Pieces Managing Common Health Conditions Slows Alzheimer's Progression

Simple treatments for four common health conditions can delay Alzheimer’s disease (AD) progression at least as effectively as the latest amyloid-targeting therapies, according to researchers at the University of Arizona in Tucson, AZ. The finding, reported in Alzheimer’s & Dementia, builds on previous research into what drives Alzheimer’s development, and could extend the window for testing new treatments that might slow progression or reverse the disease.

Scientists have long known that type 2 diabetes, hypertension, inflammation, and dyslipidemia all increase the risk of developing AD. “We’ve consistently found that indeed, if people control these conditions, there’s a significant reduction in their risk for developing Alzheimer’s disease,” says Roberta Diaz Brinton, Director of the Center for Innovation in Brain Science at the University of Arizona, Tucson, AZ. However, these interventions don’t prevent every case of AD. This led Brinton and her colleagues to ask a follow-up question: if treating these conditions reduces the risk of developing Alzheimer’s, can the same treatments also slow cognitive decline in people who already have the disease?

To answer this critical question, her team turned to the National Alzheimer’s Coordinating Center (NACC), a valuable resource offering researchers an opportunity to explore extensive and detailed participant data across decades. The NACC dataset allowed researchers to examine thousands of AD patient trajectories based on their chronic conditions and treatment histories.

Through extensive analysis of the NACC data, followed by careful validation in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset, Brinton and her colleagues demonstrated that managing the four risk factor conditions - the same strategy that reduces the risk of developing AD - also slows cognitive decline in those who do go on to develop the disease. , Brinton and her colleagues demonstrated that managing the four risk factor conditions - the same strategy that reduces the risk of developing AD - also slows cognitive decline in those who do go on to develop the disease.

Remarkable Delay in Cognitive Decline

Researchers selected more than 7,500 NACC participants who had mild dementia at their first recorded visit in the dataset who were taking medications for at least one of the four conditions identified as AD risk factors, and a control group of nearly 2,000 participants who weren’t taking any of the relevant medications. They then looked at the groups’ changes in cognitive function, using standard dementia assessments.

“Ultimately, in that analysis, we discovered something surprising to me, that people who were on a combination of four therapies, all targeting Alzheimer’s risk factors, had the greatest slowing of decline in cognitive function,” says Brinton. The result was surprising because people with all four conditions should be the ones at highest risk for AD progression. Instead, when those patients received effective treatment for all four conditions they experienced a 40-60% slower cognitive decline compared to untreated individuals, and the delay in decline seems to be sustained for at least ten years. People being treated for fewer conditions also benefited, though the effect was less pronounced.

Brinton stresses this isn’t a cure: There’s no evidence these treatments reverse dementia. However, even delaying progression can be transformative, significantly prolonging independent living. Crucially, the four treatments together, known as QuadRX, were equally effective in both male and female participants, and notably mitigated the effects of APOe4, a genetic marker associated with higher risk and worse progression of AD.

Experts across the Alzheimer’s research community are recognizing the importance of these results. Dr. Howard Fillit and other leaders note that while current amyloid-targeted therapies like lecanemab and aducanumab slow cognitive decline modestly—by approximately 27% and 22%, respectively—the QuadRx approach offers significantly greater potential benefits (Fillit, 2025).

Mechanisms Behind the Therapy

Diabetes, hypertension, inflammation, and dyslipidemia act as biological ‘on-ramps,’ accelerating Alzheimer’s progression by driving inflammation, vascular injury, and metabolic dysfunction in the brain. Brinton emphasizes that treating these conditions slows—but doesn’t eliminate—the underlying progression. She adds that effective treatments of these conditions is “not the off-ramp, but they’re slowing the on-ramp acceleration [so] we have a window in which we can intervene with novel therapeutics.”