2015 AAAS Annual Meeting (12-16 February 2015)

February 12 - 16, 2015

Worldwide Epidemic of Senile Dementias: Challenges of Preclinical Treatment

The expanding prevalence of senile dementias, including Alzheimer’s disease, is fueled by the increasing population of elderly in many countries. The combined costs of medical and custodial care have made senile dementias the most expensive diseases to treat in most advanced industrial nations. Senile dementias present slowly with a wide spectrum of complex manifestations, encompassing cognitive losses, abnormal regulation of mood and behavior, and disturbances of communication skills. By the time these signs are recognized, affected nerve cells already have been damaged beyond repair. Available treatments initiated at the onset of clinical signs all have failed. Accumulation on and in nerve cells of proteins that are altered and consequently neurotoxic is a central pathogenic mechanism in most senile dementias. Such abnormal proteins may be detected by imaging techniques and analyses of cerebrospinal fluid up to 20 years before clinical disease. Blood-based testing and new approaches to imaging are already improving the preclinical diagnostic platform. The major challenge now is to develop more simple and sensitive tests for preclinical identification of high-risk subjects who will benefit from initiation of therapy before the onset of manifest disease.