What is new in degenerative dementia disorders?

Alzheimer's disease and other degenerative disorders--dementia with Lewy bodies, frontotemporal dementia, etc.--causing about 90% of dementias in advanced age, are a major health problem of increasing practical, scientific, and socio-economic importance. Despite considerable progress in genetic, clinical and basic neurosciences, the aetiology and molecular mechanisms of these disorders are still unknown and their early diagnosis, due to lack of specific biomarkers, is still unsatisfactory. The epidemiology, risk factors, clinical and morphological diagnostic criteria, probable pathogenic factors, and molecular genetics of the major types of degenerative dementias are reviewed. Their management involves several pharmacologic, non-pharmacologic and psychosocial options. Modification of the disease by reducing known and presumable risk factors, cognitive enhancement with cholinomimetic drugs, and reduction of behavioural abnormalities with psychotropic drugs, together with informed community and private management are currently achievable goals that will serve to delay the progression of disease. In the future, these options will hopefully be replaced by more effective management strategies in order to improve the quality of life of both, patients and caregivers.