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Dementia risk is complex: aging plus genetic, environmental, and cardiovascular factors are involved. Multiple pathologic proteins with or without cerebral small vessel disease contribute to dementia presentation. No potential disease-modifying drugs have passed the rigor of clinical trials. One likely reason for their failure is that in symptomatic dementia, the proteinopathy has taken hold, so it is too late for a drug to work. Thus, the development of novel methods to identify individuals at risk for dementia using neuroimaging biomarkers is a critical line of investigation.
Footnotes
Study funding: Ontario Neurodegenerative Disease Research Initiatie (Ontario Brain Institute).
Disclosure: M.M. reports no disclosures relating to this comment. M.M. has served as an advisor to Bioscape Medical Imaging CRO, Novartis, and UCB; received honoraria from Novartis; received royalties from Henry Stewart Talks Ltd.; received an investigator-initiated research grant from Teva; received contract research support from Roche, Novartis, and Axovant; received peer-reviewed research support from Canadian Institutes of Health Research, Ministry of Research, Science, and Innovation (Ontario), Weston Brain Institute, Sunnybrook AFP Innovation Fund, Washington University, Parkinson Society Canada, Alzheimer's Drug Discovery Foundation, Brain Canada, and Ontario Brain Institute; and received salary support from the Department of Medicine at Sunnybrook Health Sciences Centre and University of Toronto and from the Sunnybrook Foundation. J.K. reports no disclosures. Go to Neurology.org/N for full disclosures.
- Copyright © 2017 American Academy of Neurology
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