[Early detection of Alzheimer's disease and approaches for prevention]

Due to the aging population, within the next 20-30 years the number of individuals with dementia, mostly due to Alzheimer's disease (AD), will drastically increase. Since a cure for the disease will not be available in the near future, early disease detection and prevention are of central importance for slowing symptom progression and maintaining independency and quality of life.In this narrative review, the current state of research in early disease detection and prediction of AD as well as lifestyle-based and molecular prevention approaches are presented.With biomarkers for the core pathology of AD, it is possible to predict the risk for dementia in individuals within the prodromal phase of the disease, which extends up to 10 years. It is estimated that up to 30% of the risk of dementia is attributable to modifiable factors. Accordingly, some multimodal lifestyle-based interventions show protective effects on cognition in at-risk subjects. Anti-amyloid treatment is currently being studied in patients with mild cognitive impairment and in individuals without symptoms, but with high genetic risk for AD.Early diagnosis, prediction, and prevention of AD are the main challenges to overcome the potentially drastic increases in individuals with dementia within the next decades. These challenges are associated with complex medical, ethical, legal, and economic questions.