Home-Based Alzheimer’s Treatment Brings Care Closer to Families

Davide Cappon, PhD, remembers how his great aunt was the heart of their Italian family gatherings—calling friends for hours, teasing relatives at dinner, filling rooms with laughter. Then Alzheimer’s arrived, and everything changed.

The memory loss came first, but what devastated the family wasn’t what she forgot, it was how she began pulling away from everyone she loved.

“She stopped joining our family events, our family dinners, and she used to be the life of the party,” Dr. Cappon recalled.

Today, he channels this experience into groundbreaking research, alongside Brad Manor, PhD, and Alvaro Pascual-Leone, MD, PhD, as part of an Alzheimer’s Disease Research-funded team at Harvard Medical School and Hebrew SeniorLife.

The team is studying brain stimulation treatments that can take place at home, targeting multiple symptoms of Alzheimer’s disease simultaneously. Dr. Cappon’s grant investigates depression and memory in people with Alzheimer’s, while Dr. Manor and Dr. Pascual-Leone’s grant examines memory and executive function—mental skills that help people stay organized, focused, and in control of their actions.

Their timing couldn’t be more critical. “Cognitive decline due to neurodegenerative diseases is the biggest cause of disability for humans nowadays, more than cancer or cardiovascular disease together,” said Dr. Pascual-Leone. This approach to Alzheimer’s treatment could help overcome barriers that older adults and their families face after diagnosis and offer hope for a better quality of life.

Two Problems, One Bold Solution

Brain stimulation for Alzheimer’s isn’t new, but it has always worked like trying to fix a broken orchestra by tuning just one instrument at a time. Researchers might use transcranial electrical stimulation—gentle currents applied through electrodes on the scalp—to target memory circuits. Or executive function circuits that control planning and decision-making. Or circuits involved in depression. But never more than one at once.

Dr. Manor and Dr. Pascual-Leone’s research asks a deceptively simple question: Can we address more than one symptom at a time?

Their approach combines two different types of transcranial current stimulation simultaneously. Think of it as conducting multiple sections of that broken orchestra at once, memory networks and executive function networks working in harmony rather than isolation.

“It was kind of a no brainer to say, ‘Well, if a patient is really being affected by both things at once, why not deliver stimulation to both circuits at once?'” Dr. Manor explained. “Hopefully [that will] improve both of those symptoms, and as a result, have a much larger, more than additive effect on function and daily life activity.”

Using magnetic resonance imaging (MRI) scans, the team maps each participant’s individual brain anatomy, then collaborates with other research groups who model exactly where the electrical fields will travel. This precision allows them to reliably target the specific brain networks that control memory formation and executive function, networks that operate differently in people with Alzheimer’s.

Meanwhile, Dr. Cappon is applying this multi-network approach to people like his great aunt who developed both Alzheimer’s and depression. Depression is sometimes the very first symptom of Alzheimer’s, as Dr. Pascual-Leone pointed out, often presenting as apathy or lack of motivation in someone in their 60s or 70s who maybe never had depression before.

“When Alzheimer’s and depression occur together, which they often do, the challenges are many,” Dr. Cappon explained. “Generally speaking, people with both conditions decline more quickly (cognitively), experience greater disability, and they have a greater burden for families and caregivers.”

Older adults typically do not respond as well to traditional anti-depressants, according to Dr. Cappon, as later life depression often presents with more complexities and co-occurring conditions, limiting treatment options. His research uses brain stimulation to address both depression and cognitive decline simultaneously without the use of medications.

“If we are successful, the ultimate goal is to offer a more effective alternative that truly meets the needs of older adults and help them maintaining higher quality of life,” he said.

Brain Treatment From the Comfort of Home

The team aims to move Alzheimer’s treatment out of sterile medical centers and into the home.

The logistics seemed impossible at first. Brain stimulation typically requires specialized equipment and trained technicians. How could family members possibly learn to deliver precise electrical currents to specific brain regions?

And yet, they’ve done it. The very first person Dr. Manor trained to do this was an 86-year-old woman treating her husband’s Parkinson’s disease at home. “Within three days they were able to deliver the stimulation and that really opened my eyes to the possibility.”

The process isn’t as intimidating as it sounds. After the training, several participants told Dr. Pascual-Leone that they felt empowered and the 30-40 minutes of treatment a day became an important anchor in their experience. For many families, having something to do, some way to fight back against a disease that usually leaves them feeling helpless, means everything.

Enabling at-home Alzheimer’s treatment solves multiple problems. Many people with Alzheimer’s face “mobility limitations, caregiver responsibilities, and transportation difficulties, including the distance [to] specialized clinic[s],” Dr. Cappon noted. But more importantly, effective brain stimulation requires consistency.

“We envision that brain stimulation is not going to be a short-term intervention,” Dr. Manor explained. “For it to have lasting effect, there’s going to need to be regular exposure. For example, in our current work we are exposing people to stimulation every day. Or maybe five times a week for many weeks.”

Expecting someone with Alzheimer’s to travel across Boston for daily treatments? “It’s just completely not feasible,” he added.

Progress Built on Collaboration

The research team has already shown that brain stimulation targeting both depression and memory networks can improve not just mood and cognition, but daily functioning overall.

They are also investigating how to optimize stimulation dosage for individual participants. By analyzing blood markers of neurodegeneration and studying how electrical fields interact with each person’s unique brain anatomy, they’re laying groundwork for personalized treatment.

“The goal is to develop, ultimately, a real precision medicine approach where one can take specific patients and say, ‘Okay, what is it that would be the best intervention for this person given the biology on the one hand and on the other hand, given their self-report of what is bothering her or him the most,'” said Dr. Pascual-Leone.

What makes this research possible is the kind of collaboration that’s increasingly rare in academic science. Dr. Cappon was previously a postdoctoral researcher for Dr. Pascual-Leone when he was at Berenson Allen Center. Dr. Manor already worked at Hebrew SeniorLife and connected with Dr. Pascual-Leone as they had similar research interests. Dr. Cappon and Dr. Pascual-Leone then moved to Hebrew SeniorLife, and the group was able to work closer together.

“By having this kind of an interdisciplinary, team-based approach, it allows us to answer questions that we would not be able to otherwise,” said Dr. Manor.

Connection Restored

Dr. Cappon still thinks about his great aunt, about how depression robbed her of the desire to connect with people who loved her. Funding from Alzheimer’s Disease Research has been pivotal in supporting his journey to provide better treatments for people with depression and Alzheimer’s.

“I think especially for younger investigators and faculty at the beginning of your career, it’s really hard to get funded by federal funding now, and I think foundation grants [have] become even more important,” he said.

The team feels immense gratitude for the donors that have championed their work. For families currently navigating an Alzheimer’s diagnosis, this research offers genuine hope grounded in scientific innovation. “We’re very honored to have received this funding and we 100% agree with the mission of BrightFocus and hope that the work that we’re doing can be beneficial to all,” said Dr. Manor.

Together, their work represents a fundamental shift from asking families to adapt to medical limitations to adapting medical treatment to serve families’ real needs—bringing healing into the comfort of home, where connection and care have always belonged together.

With the support of our generous community, Alzheimer’s Disease Research is funding more than $30 million in cutting-edge studies worldwide. Every gift moves us closer to ending this devastating disease. Discover how you can help support our work.