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ly and social environment concerning lence and incidence are changing over
affective, organizational, and economic time. To establish clear trends, these
aspects. In this sense, dementia should comparisons should be based on stu-
be understood as a social problem that dies that use similar diagnostic and re-
must be approached in a comprehen- search methods consistently over time.
sive manner. It is important to bear in mind that the
main non-genetic risk factors for the
The transition from a cognitively heal- development of dementia are related
thy stage to an AD-type dementia is to lifestyle, which makes it particularly
a continuum in which some interme- important to carry out studies in the
diate stages, preclinical and prodromal Spanish population. Important chan-
can be recognized. These stages are ges in our society and improvements
characterized by the presence of an in living conditions and education in
incipient cognitive impairment that recent decades can have a decisive
increases the probability of conversion influence not only on physical well-
to dementia in the future. An effecti- being, but also mental and cognitive
ve therapeutic intervention in these health and therefore on the incidence
phases prior to AD could eventually of dementia in the elderly population.
slow the progression of deterioration Thus, the analysis of risk factors related
and thus reduce the prevalence of the to the symptoms of dementia must
disease. For this reason, one of the be accompanied by a comprehensive
challenges currently faced by research phenotypic characterization in order to
is the development of useful tools that provide a better understanding of the
allow early diagnosis of AD.
underlying neurobiological mechanis-
Currently, there is no reliable method ms.
to predict safely which individuals in The concept of population studies -
these preclinical stages have an in- that is, the recruitment of participants
creased risk of converting to dementia. from community environments to en-
The emergence in the last decade of sure good representations of the entire
various diagnostic neuroimaging tech- population - must be incorporated in
niques (eg, brain PET amyloid) has led future neurobiological and neuropa-
to considerable progress in research, thological investigations in demen-
although its use in regular clinical tia. The results of small clinical-based
practice is not feasible due to its high samples, which include only patients
cost.
from memory clinics or other medi-
The most recent descriptive epide- cal services, have inherently limited
miological research on dementias is generalization and the considerable
allowing us to investigate how preva- potential for bias due to highly selec-
