Showing papers by "David Neary published in 2019"
TL;DR: It has been accepted for many years that Alzheimer's disease (AD) is the main cause of dementia in most if not all parts of the world and there are a number of risk factors such as increasing age, apolipoprotein E ε4 genotype, and a host of medical risk factors.
Abstract: It has been accepted for many years that Alzheimer's disease (AD) is the main cause of dementia in most if not all parts of the world. It is a very complex disorder and its underlying pathological mechanisms are still poorly understood. There are a number of risk factors. These include increasing age, apolipoprotein E ε4 genotype, a number of different autosomal dominant genetic mutations that especially affect younger people, and a host of medical risk factors such as hypertension, diabetes mellitus, hypercholesterolaemia, lack of exercise and obesity to name but a few. Modestly effective symptom treating drugs such as the cholinesterase inhibitors and memantine, and N-methyl-D-aspartate receptor antagonist, have been available for many years but despite fi fteen to twenty years of research endeavour we still do not have any AD targeted disease modifying drug treatments that delay or prevent the pathology. All of the trials of the latter have failed so far despite many different underlying strategies. This could be the result of all the trials being of a monotherapy, or targeting the wrong pathological process, or trying to develop a single \"magic bullet\" approach that would benefit all patients with AD, or a combination of these factors acting alone or together with intrinsic risks factors such as those mentioned above.