Can we afford to develop treatments for dementia?

• neurodegenerative disorders

This issue and that of the BMJ (22nd June 2002), are dedicated to neurodegenerative disorders. We have come a long way in this field over the past two decades or so. Twenty years ago we knew only that Alzheimer's disease (AD) affected many elderly people, segregated in some early onset families, and was predominantly a disorder of cholinergic function. Now we have five years of postlicencing experience with the first drugs designed to rectify that cholinergic deficit1 and our understanding of the molecular basis of AD is, if not complete, pretty much understood in outline. We know how the amyloid of plaques is produced in some detail and in the case of early onset familial AD we know why.2 For late onset AD the influences on amyloid formation, aggregation, and deposition are less well understood, but we do know of some environmental influences such as head injury3, 4 and some genetic ones such as …