Alzheimer’s disease 2011. Where are we heading?

Alzheimer’s disease (AD) is a major problem of health and disability, with a relevant economic impact in our society (€177 billion in Europe). Despite important advances in pathogenesis, diagnosis and treatment, its primary causes still remain elusive, accurate biomarkers are not well characterized, and the available pharmacological treatments are not cost-effective. As a complex disorder, AD is a polygenic and multifactorial clinical entity in which hundreds of defective genes distributed across the human genome may contribute to its pathogenesis (with the participation of diverse environmental factors, cerebrovascular dysfunction, and epigenetic phenomena), leading to amyloid deposition, neurofibrillary tangle formation and premature neuronal death. Future perspectives for the global management of AD predict that structural and functional genomics and proteomics may help to search for reliable biomarkers, and that pharmacogenomics may be an option to optimize drug development and therapeutics.