If you mention to a neighbour or friend that you work in neuroscience, it is almost a metaphysical certainty that the first thing they say will be, “That must be... interesting.” “Yes,” you might say, “or at least I think it is.” At which point either the conversation will turn to the weather (at least in the UK), or they will ask you why you and your colleagues can't cure Alzheimer's disease (or possibly Parkinson's) yet.

What do you say? You can explain that it takes a long time to test potential treatments for safety and efficacy, but that there are a number of new drugs in clinical trials; you can tell your friend how important ongoing animal research is for a better understanding of the cause of the disease, to enable us to treat it more effectively; but there is no easy answer. The truth is that Alzheimer's disease is an enormous global problem and that doctors can currently do very little to slow its relentless progression.

But there is hope. In his review on page 677, Martin Citron describes the most promising new therapeutic avenues for Alzheimer's disease. Neuroprotective strategies, drugs designed to interfere with the amyloid cascade, and treatments devised on the basis of epidemiological data — such as non-steroidal anti-inflammatory drugs (NSAIDs) or cholesterol-lowering statins — are all poised to enter clinical trials, or are already in the first stages of such trials. As Citron points out, if approaches that involve reducing amyloid production or aggregation prove successful, they would produce the first drugs to modify the pathogenic mechanism in a disease of the CNS. Such drugs would represent a huge breakthrough in healthcare, and would bring with them the hope of a healthier, happier old age for a large part of the population.