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Neurodegenerative diseases are characterized by the progressive loss of neuronal function and structure, often leading to motor and cognitive impairments. The intricate molecular mechanisms underlying these diseases involve key pathways such as cholinergic signaling, oxidative stress, amyloid-beta aggregation, tau protein hyperphosphorylation, mitochondrial dysfunction, and neuroinflammation. Rivastigmine, a potent cholinesterase inhibitor, has emerged as a promising therapeutic agent due to its dual inhibitory effects on acetylcholinesterase and butyrylcholinesterase, enhancing cholinergic neurotransmission. This review provides a comprehensive overview of the molecular pathways implicated in neurodegenerative diseases and critically examines the therapeutic potential of Rivastigmine. Emphasis is placed on its mechanism of action, clinical efficacy, and limitations in addressing neurodegeneration. Current advancements, clinical trial outcomes, and potential future directions are discussed to highlight the utility of this approach in the treatment of neurodegenerative disorders.
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