Emerging strategies for the treatment of Alzheimer’s disease at the Millennium

1. Summary It is estimated that by the year 2050 the number of cases of Alzheimer’s disease (AD) will more than triple in the United States alone. As longevity increases, AD cases are expected to skyrocket fro m4-1 4 m.Globally, the numbers may reach 60 - 80 m. Those expected to develop AD in the next century are presently in their 20s, 30s or 40s. Thus, steps must be taken to prevent this imminent epidemic, and the emotional and economic toll that it will exact on both patients and families. Numerous new strategies to treat AD have emerged in the last decade. This is the direct result of an increased understanding of the molecular pathology associated with the development of AD dementia, as well as the harvesting of results from case-control and cohort epidemiological studies. AD is no longer viewed solely as a disease of neurotransmitter deficits or amyloid deposition. Rather, it is a combination of events (amyloidosis, neurofibrillary pathology, inflammation, oxidative stress and cerebral vascular insufficiency) that conspire to produce this dementia. This avalanche of information reveals the complexity of the genetic and environmental contributors to AD. At the same time, these advances also delineate new avenues by which AD may be palliated, halted or averted. In the present review, we shall explore the emerging opportunities for the treatment and prevention of AD.