The problem with Alzheimer's disease

Despite decades of intensive research, progress in treating late-onset Alzheimer's disease remains limited. A central problem may be conceptual: Alzheimer's disease may not be a single disease, but a heterogeneous syndrome arising from differing combinations of aging, genetic susceptibility, vascular injury, metabolic stress, inflammation, and other pathologies. Research has focused largely on biomarkers rather than the pathways leading to them. The dominance of amyloid- and tau-centered models, together with limited animal models, may constrain therapeutic progress. A more productive strategy may require an integrated, personalized approach targeting the relevant contributing and modifiable factors in each individual.