Dementia Research: Populations, Progress, Problems, and Predictions.
Journal of Alzheimer's disease : JAD
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Hunter, S., Grbic-Smailagic, N., & Brayne, C. (2018). Dementia Research: Populations, Progress, Problems, and Predictions.. Journal of Alzheimer's disease : JAD, 64 (s1), S119-S143. https://doi.org/10.3233/jad-179927
Alzheimer 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 ageing 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 ageing 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 ageing 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 towards therapeutic interventions can be made.
Animals, Humans, Dementia, Biomedical Research
Paul G Allen Family Foundation (12076)
External DOI: https://doi.org/10.3233/jad-179927
This record's URL: https://www.repository.cam.ac.uk/handle/1810/273991