Dementia used to be seen as an inevitable stage in life, not a disease. We now know more about Alzheimer's disease and there are reasons for optimism.

More educated people suffer the disease less severely or develop it at a later age. And many people reach their nineties with no trace of it.

Dementia is characterised by gross changes in brain structure - tangles of protein and plaques. The disease is selective in those it attacks and has manifest symptoms, suggesting that drugs that affect the behaviour of proteins may modify its course. But the main advances have been in controlling symptoms. Restoring memory and cognitive ability has proved harder.

Several emerging drugs target amyloid-beta, a protein in the brain, but some scientists doubt that this is the only factor at play. Evidence presented at the International Conference on Alzheimer's Disease suggests that a direct attack on the tangles of tau protein could be more effective.

It may be some time before we can say that dementia is a controllable disease, but 100 years after Alzheimer's was identified, that no longer seems to be an unreasonable objective.

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