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F1‐04‐04: The search for effective therapies for ad and related disorders must not be abandoned, and biomarkers will be important in that search
Author(s) -
Fox Nick C.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.07.021
Subject(s) - disease , medicine , clinical trial , frontotemporal dementia , biomarker , intervention (counseling) , intensive care medicine , bioinformatics , dementia , psychiatry , biology , pathology , genetics
in research which has produced major advances in understanding of brain aging and pathophysiology of AD, lack of any practical, translatable value has moved the field to newfound efforts to detect preclinical disease in hopes of discovering a drug or drugs that would interrupt neurodegenerative processes leading to AD and Late life Dementias (LLD). Methods: For this strategy to be effective it is likely that a huge proportion of the population would need some kind of long term treatment and that treatment would have to be virtually completely without side effects, an unlikely possibility given the complexity and widespread nature of the nervous system. In addition, older persons with AD also have other neurodegenerative processes which contribute to the clinical dementia phenotype. A single “silver bullet” safe medication seems highly unlikely. Results: AD and LLDs like most common chronic diseases are now known to involve multiple risk factors. Improvement in education and socioeconomic well being along with control of vascular risk factors are associated with reduced rates of AD and LLD. Logical interventions to further reduce risk are well known but notwidely practiced but are virtually risk free.What is lacking is understanding of how risk factors lead to lower rates and ways to increase adoption and adherence of public health and personal health practices. A better goal, which is consistent with goals of prevention and treatment of other late life conditions, is to strive for a compression of cognitive morbidity: As longevity increases, time of functional impairment is moved closer to time of death. Conclusions:A better approach to the public’s investment into AD research should place more resources in community based, life course epidemiology research, ideally linked to traditional neuroscience research laboratories. Population based research using this model can help avoid misleading, and on occasion frank errors that have led to public disappointments and poor use of research funds.