When asked to select the most important advances in dementia in 2018, as seen through a small number of papers (out of the tens of thousands published), I was presented with a real challenge. The dementia research literature spans a huge range of subject areas, such as ageing, gerontology, developmental research, neuroscience, social science, ethics, law, engineering, architecture, and even environmental research. The academic literature reports on prevention, screening, early detection, treatment of symptoms, and end of life care . No one researcher can cover all these territories, and the meaning of ‘best’ will vary hugely accordingly to an investigator’s discipline and overall perspective. Given this complexity, I have chosen to reflect on changing approaches to dementia and have selected papers that use different methodologies and come from different disciplines.