Alzheimer's disease consists of a progressive deterioration of brain cells, resulting in a progressive loss of the report and other alterations of the functions regulated by the brain: thinking, movements, etc.

The progress in the knowledge of this disease in the last twenty years has been very important. Today we know that this degeneration is not instantaneous, but takes place over a long period of time (years). Therefore, we can also foresee that we have a certain margin (therapeutic window) to try to correct the neurodegenerative process. The question is to know at what point in the process and with which drug we can deal with it.

There are currently five treatments approved by the health authorities; all five target some of the clinical symptoms associated with Alzheimer's disease, but none of these treatments has the capacity to slow down the degenerative process. Therefore, it is easy to conclude that the challenge we are facing is to be able to elucidate the neurodegenerative cascade of Alzheimer's; this previous knowledge is essential to be able to identify new molecular targets that, in turn, will allow the development of new drugs capable of neutralizing the deterioration of neurons.

An idea that is increasingly being accepted by researchers at area is that the "effective treatment" of Alzheimer's disease will involve a cocktail of drugs directed against different targets; this would be very similar to what is currently happening with other complex diseases such as AIDS, cancer or hypertension.

Currently, the targets for which new molecules are being designed that will be the embryo of the next generation of anti-Alzheimer's drugs are aimed at neutralizing three of the characteristic pathological features of this dementia: the accumulation of amyloid beta, the training of Tau neurofibrillary tangles and the inflammatory process that occurs as a result of the two previous events. These three strategies would try to slow down neurodegeneration.

In my opinion, and that of other colleagues, a fourth strategy should be aimed at restoring neuronal plasticity. This option will help the neuron to maintain its functionality. The most incipient losses of report are caused by the inability of the neuron to synthesize the proteins necessary to form and sustain the synapse (technically known as "neuronal plasticity"). There is a group of molecules, some used for the treatment of other diseases, with these capabilities. This is therefore a promising target with the potential to be tested in humans in the near future deadline.

In parallel to the research on new drugs, we cannot forget the development of new imaging techniques and biomarkers that will make it possible to determine the risks of developing Alzheimer's disease. This facet is the one that has achieved the most success so that today neuroimaging is capable of revealing, in advance of symptoms, the morphological changes associated with this dementia. This strategy, together with the availability of drugs, will make it possible in a future that is difficult to specify, to cure, prevent or delay the characteristic symptoms of Alzheimer's disease.

Preventive medicine

And for us what For us it remains certain that some risk factors that favor the development of Alzheimer's disease, mainly cardiovascular factors, can be corrected. Smoking, excessive drinking, stress, sedentary life or obesity are habits whose correction is among our possibilities. Preventive medicine is the most effective, the least costly and the most satisfying.

I cannot end this brief account of the state of the art without paying tribute to the caregivers of Alzheimer's patients, especially the obligated caregivers; that wife, husband, daughter, son, at final the family. People who suffer from Alzheimer's disease as much or more than the patients themselves; often abandoned to their fate by the responsible authorities. I will end with a fact. group A few years ago, a group of experts met at the National Institutes of Health in Bethesda, USA, to discuss new strategies in the study of Alzheimer's disease and to make recommendations to the government. Among other things, they concluded that the real cost of the complete treatment and care of an Alzheimer's disease patient was around 36,000 euros/year. The Spanish Confederation of Associations of Relatives of People with Alzheimer's and other Dementias (CEAFA) estimates that there are 1.2 million people with Alzheimer's in Spain. Nothing more needs to be said.