Commentary on “Diagnosis of Alzheimer's disease: Two decades of progress”

Dr. Khachaturian’s review provides a high-level overview of the progress that has been made, particularly in the last 20 years, in understanding the neurobiology and clinical presentation of Alzheimer’s disease. More importantly, it shows how well-directed basic biomedical and clinical research has changed the public perception of this disease and has improved the clinical management of affected patients. Alzheimer’s disease will continue to afflict many people for years to come, but the care that these patients receive will be more effective and more humane than would be the case without the work described by Dr. Khachaturian. Additionally, the knowledge gained over the last 2 decades provides a solid scientific foundation that will make further advances in diagnosis, treatment, and prevention much more likely. The events and developments surrounding the diagnosis of AD over the past 20 to 30 years highlight at least 3 issues that are important for an effective biomedical research enterprise, particularly a disease-focused enterprise. They are, first, an appropriate balance of individually driven, investigator-initiated research and larger, multicenter, institutionally guided research; second, the key role that government officials can make in guiding research efforts across many institutions toward common public health goals; and, third, recognition of the unique, complimentary, and essential contributions of government agencies, academic institutions, patient advocacy groups, and for-profit corporations in the biomedical enterprise.