Nakagawa_2005_Rinsho.Shinkeigaku_45_857

As growing population of the elderly over 65 years of age, dementia will be one of the most important diseases in Japan. To defeat the dementia, the following strategies would be needed; 1) acceleration of basic research for dementia, 2) acceleration of clinical research for dementia, 3) development of care system for patients with dementia, and 4) provision of social basis for the elderly. On the basis of an understanding of the pathophysiology, treatments of Alzheimer's disease includes the following components: antiamyloid therapies including secretase inhibitors, metal binding agents and Abeta vaccine, neuroprotective strategies, cholinesterase inhibitors, memantine, immunotherapy including Abeta vaccine, anti-inflammatory therapy, hormone-replacement therapy, psychopharmacologic agents, nonpharmacologic interventions and health maintenance activities, and an alliance between clinicians and family members and other caregivers responsible for the patient. The combination therapies with pharmacologic and nonpharmacologic components are probably useful for patients with Alzheimer disease or other dementia. In addition, development of accurate diagnostic methods of dementia and the early detection system of amyloid in the brain are expected. Responsibility of neurologist for dementia is getting important next 10 years in Japan.