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• W2336704020 abstract "Abstract The development of more effective treatments for dementia, particularly Alzheimer′s Disease is a major global challenge requiring international collaboration and cooperation Basic neuroscience discoveries, novel approaches to development of medications and a spirit of innovation in long term care will serve us well as we approach the next millennium The world is continuing to age at a rapid rate In countries that are industrialized, prevalence rates of individuals over the age of 65 are now approaching 20%.In the future more older people will live in the less industrialized parts of the world and the rate of aging in some of those countries is even greater than those in western Europe and North America China, for example, has implemented a successful birth control program that will lead to a larger number of individuals surviving into their later years However the combination of more older people with fewer younger people to develop and maintain the economy will lead to potentially tremendous econoinic difficulties that will be shared by the countries around the world at different times during their development Unfortunately, older individuals are more at risk for cognitive impairment due to dementia The most common dementia in the world for older individuals is probably Alzheimer′s Disease, although in some countries vascular dementia rivals that claim Alzheizer′s Disease is a progressive neuropsychiatric condition in which death of nerve cells are associated with patholngical hallmarks, namely senile plaques and neurofibrillary tangles (Whitehouse et al, 1982 [12] ) The death of nerve cells occurs in selective populations, including cholinergic basal forebrain, bioaminergic locus coeruleus and raphe nuclei, hippocampus amygdala and various regions of the neocortex This cell loss is associated with loss of neurotransmitter markers including acetyl choline, noradrenaline, serotonin, corticotrophin releasing factor and somatostatin (Price et al, 1986, [11] ) In the early stages of disease it may be difficult to differentiate Alzheimer′s Disease from normal age related cognitive decline In the mild stages, loss of memory and attention is sometimes associated with changes in personality In the moderate stages the cognitive problems progress to involve language and perception and the patient becomes partially dependent on others for their activities of daily living, In the final stages, the patient′s cognitive impairment progresses to the point where they may not be able to recognize family or even speak and they may become completely dependent on their caregivers The course with vascular diseases is somewhat different, as the etiology appears most commonly to be multiple small strokes, although other pathogenic mechanisms might be at work Thus, the clinical course is frequently stuttering and the pattern of neuropsychological disabilities variable depending on where the strokes appear The diagnostic criteria for vascular dementia are a little less clear than Alzheimer′s Disease, thus the rates of multi infarct dementia diagnosed in different countries varies (McKhann et al 1984; NINCDS AIREN, [19] ) A combination of vascular dementia and Alzheimer′s Disease is also a common cause of dementia In this paper we will review the biological treatments of Alzhemier′s Disease,focusing on current efforts to produce drugs to improve symptoms as well as to alter the natural course of the illness Finally, we will make some comments about non biological therapies and the importance of integrating them with drug treatment We will conclude by discussing some of the future opportunities and challenges that lie ahead" @default.
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• W2336704020 date "1998-01-01" @default.
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• W2336704020 title "Global drug development in dementia" @default.
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