Alzheimer's disease research: past approaches and future directions

Background: Three decades after the amyloid cascade hypothesis was first proposed, research into discovery of effective treatments for Alzheimer's disease has not yet produced any disease-modifying treatments. Aims: This review outlines the progress made by dementia research thus far, and provides a brief overview of the therapeutic approaches resulting from the amyloid cascade hypothesis. It then describes the shift in research focus to the early stages of the condition, the challenges it presents and potential consequences for care. Methods: A literature overview was undertaken by reviewing research papers, published protocols and policy guidelines. Findings: Past research has failed to produce effective treatments for dementia, yet the causes of this failure remain debated. Discovery of affordable, early biomarkers has emerged as a key target of investigation as the focus has shifted from treatment to prevention of the condition. Conclusions: Failures in identifying effective treatments for dementia have highlighted the importance of earlyidentification and intervention in patients as a way to prevent neurodegeneration and progression to dementia. Discovery of biomarkers is a key focus of current research. In the future, regular screening for dementia may be recommended for all older people in an effort to assess individual risk. Care may reflect a combination of early pharmacological interventions and lifestyle modification programmesbased on risk.