Page 78 - MaquetaFundCIEN-2019-ENG

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Annual Report 2019
tional and economic aspects. In this sense, dementia should be understood as a social problem that must be approached in a comprehensive manner.
The transition from a cognitively healthy stage to an AD-type dementia is a continuum in which some intermediate stages, preclinical and prodromal can be recognized. These stages are characterized by the presence of an incipient cognitive impairment that increases the probability of conversion to demen- tia in the future. An effective therapeutic intervention in these phases prior to AD could eventually slow the progression of deterioration and thus reduce the prevalence of the disease. For this reason, one of the challenges currently faced by research is the development of useful tools that allow early diagnosis of AD.
Currently, there is no reliable method to predict safely which individuals in these preclinical stages have an increased risk of converting to dementia. The emer- gence in the last decade of various diagnostic neuroimaging techniques (eg, brain PET amyloid) has led to considerable progress in research, although its use in regular clinical practice is not feasible due to its high cost.
The most recent descriptive epidemiological research on dementias is allow- ing us to investigate how prevalence and incidence are changing over time. To establish clear trends, these comparisons should be based on studies that use similar diagnostic and research methods consistently over time. It is important to bear in mind that the main non-genetic risk factors for the development of dementia are related to lifestyle, which makes it particularly important to carry out studies in the Spanish population. Important changes in our society and improvements in living conditions and education in recent decades can have a decisive influence not only on physical wellbeing, but also mental and cognitive health and therefore on the incidence of dementia in the elderly population. Thus, the analysis of risk factors related to the symptoms of dementia must be accompanied by a comprehensive phenotypic characterization in order to provide a better understanding of the underlying neurobiological mechanisms.
The concept of population studies - that is, the recruitment of participants from community environments to ensure good representations of the entire popu- lation - must be incorporated in future neurobiological and neuropathological investigations in dementia. The results of small clinical-based samples, which include only patients from memory clinics or other medical services, have inher- ently limited generalization and the considerable potential for bias due to high- ly selective recruitment. In particular, people who are socially disadvantaged are less likely to participate in that research. The integration of neuroscience with population studies and neuroscientific epidemiological approaches is of vital importance and provides the opportunity to integrate the understanding of brain health, neurobiology and neuropathology within the general population to support better prevention, care and cure of dementia.
The main objective of the population-based study “Vallecas Project” for Early Detection of Alzheimer’s Disease, is to elucidate, through tracking of progres-