Dementia Research: Populations, Progress, Problems, and Predictions

Abstract

Alzheimer's disease (AD) is a clinicopathologically defined syndrome leading to cognitive impairment. Following the recent failures of amyloid-based randomized controlled trials to change the course of AD, there are growing calls for a re-evaluation of basic AD research. Epidemiology offers one approach to integrating the available evidence. Here we examine relationships between evidence from population-based, clinicopathological studies of brain aging and a range of hypotheses from all areas of AD research. We identify various problems, including a lack of systematic approach to measurement of clinical and neuropathological factors associated with dementia in experimental and clinical settings, poor understanding of the strengths and weaknesses of different observational and experimental designs, a lack of clarity in relation to disease definitions from the clinical, neuropathological, and molecular perspectives, inadequate characterization of brain aging in the human population, difficulties in translation between laboratory-based and population-based evidence bases, and a lack of communication between different sections of the dementia research community. Population studies highlight complexity and predict that therapeutic approaches based on single disease features will not be successful. Better characterization of brain aging in the human population is urgently required to select biomarkers and therapeutic targets that are meaningful to human disease. The generation of detailed and reliable evidence must be addressed before progress toward therapeutic interventions can be made.

Genetic Counselling Improves the Molecular Characterisation of Dementing Disorders

“…Furthermore, a risk estimation for relatives of VaD patients should take into consideration all environmental factors (cardiovascular, thrombotic, metabolic, etc.) [66].…”

Spectrum-specific encephalography standardized low-resolution brain electromagnetic tomography network and gray matter correlations in vascular dementia patients

“…3,4 The early stage of dementia such as mild cognitive impairment (MCI) and mild dementia should be well explored for the clinic observation and therapy strategy. 5,6 Imaging methods, including computed tomography (CT) and magnetic resonance imaging (MRI), are the most popular and convenient examinations for neurology diseases. Parietal lobes were found to be impaired in the VaD patients in the MRI-based observational study.…”