Last week, over 7,000 Alzheimer’s and dementia researchers from around the globe gathered in Toronto for the Alzheimer’s Association International Conference. 

The new research they shared highlights the importance of managing lifestyle risk factors to treat Alzheimer’s, reinforces the safety of anti-amyloid drugs on the market, and sets the stage for trials of faster, safer medications. Here are a few of the week’s biggest takeaways.

1. How safe is anti-amyloid drug Leqembi?

Drugs can look promising in clinical trials, but side effects often crop up more frequently once a drug is widely used. So far, that doesn’t appear to be the case with Leqembi.

Data from researchers around the world show that brain swelling or brain bleeds — side effects known as ARIA — are occurring at similar rates as in trials. In some studies, these rates are even lower. Experts credit doctors’ careful adherence to safety protocols. However, it’s still too soon to say how much Leqembi slows cognitive decline over the long term.

2. A combination of lifestyle changes could slow cognitive decline

Vigorous exercise, a healthy diet, and keeping the brain active all help protect against cognitive decline.

Results from the U.S. POINTER study show that combining these habits into a structured program — with coaching and support — slowed brain aging by up to two years. Participants in the program performed slightly better than those who tried to make changes on their own. Future research will explore how these lifestyle changes affect Alzheimer’s biomarkers in the blood and spinal fluid.

3. Taking cardiovascular disease drugs could lower the risk of cognitive decline

Could inexpensive, existing drugs help prevent Alzheimer’s? Dr. Roshni Biswas of the Rush Alzheimer’s Disease Center presented data showing that people who took medications to treat cardiovascular conditions — like high blood pressure, diabetes, or high cholesterol — experienced slower cognitive decline and had fewer plaques compared to those who didn’t.

This observational study can’t prove these drugs directly protect the brain, but it reinforces the longstanding idea that what’s good for the heart is good for the brain.

4. New guidelines provide clarity on Alzheimer’s blood tests

The Alzheimer’s Association shared new guidance to help clinicians choose the right blood tests for patients.

For now, testing people without symptoms isn’t recommended. Lower-accuracy tests may be useful for determining who should get further testing, while highly accurate blood tests could eventually replace PET scans or spinal taps in diagnosing Alzheimer’s. These guidelines will continue to evolve as evidence grows.

5. Roche’s Alzheimer’s drug busts plaques faster, safer than other mABs

Current anti-amyloid drugs don’t cross easily into the brain, so they require higher doses — raising costs and side-effect risks.

Roche’s new drug, trontinemab, is designed to penetrate the brain more effectively. In an early trial, 91 percent of participants were no longer amyloid positive after 24 weeks. Side effects like ARIA were far less common than with Leqembi or Kisunla. Roche will begin Phase 3 trials later this year to see if the drug also slows cognitive decline in early Alzheimer’s.