The earlier the better: Alzheimer's prevention, early detection, and the quest for pharmacological interventions

Cult Med Psychiatry. 2014 Jun;38(2):217-36. doi: 10.1007/s11013-014-9370-2.


Although the risk factors, biomarkers, and medications for Alzheimer's disease appear to be almost identical in 1993 and 2013, profound changes can de detected throughout this time period. This article maps these recent changes in the conceptualization of Alzheimer's disease, especially the emerging trend toward prevention. While some preventive practices (e.g., brain training) and the search for early signs and biomarkers (such as APOEε4) have existed for a long time, the recent broadening of scope to include cardiovascular risk factors and their prevention, paired with pre-symptomatic detection of disease-specific biomarkers, has considerably impacted the conventional understanding of this syndrome and the possibilities for pharmacological and non-pharmacological interventions. The rationale for emphasizing multiple logics when explaining these changes is to avoid simplified argumentative pathways that exist among some scientists.

MeSH terms

  • Age of Onset
  • Alzheimer Disease* / diagnosis
  • Alzheimer Disease* / epidemiology
  • Alzheimer Disease* / prevention & control
  • Asymptomatic Diseases / psychology
  • Biomarkers / analysis
  • Biomedical Research / ethics
  • Biomedical Research / methods
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / psychology
  • Complicity
  • Diagnosis, Differential
  • Early Diagnosis
  • Early Medical Intervention* / methods
  • Early Medical Intervention* / trends
  • Humans
  • Nootropic Agents / therapeutic use*
  • Primary Prevention* / ethics
  • Primary Prevention* / methods
  • Primary Prevention* / trends
  • Risk Factors


  • Biomarkers
  • Nootropic Agents