The failure to date of all disease modifying therapies for Alzheimer's disease and related dementias requires a serious rethinking of the field's approach to therapeutic interventions. This begins with the acknowledgement that the great majority of sporadic neurodegenerative dementias are the result of more than one toxic protein/species. While there are challenges to the initiation of clinical trials targeting more than one mechanism, there is an urgent need for a paradigm shift where a pleotropic and personalized approach is implemented to address the devastating personal and societal consequences of neurodegenerative dementias.
Keywords: Alzheimer's; Combination therapy; Misfolded proteins; Neurodegeneration; Neuroimmunology; Neuroinflammation; Proteinopathy; Ventricular-peritoneal shunt.
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