5 3ear
Colleagues,This
second issue of Dialogues in Clinical Neuroscience was
planned and coordinated by BarryLEBOWITZ
from the Adult and Geriatric Treatment and Preventive Interventions Research Branch
atthe National
Institute of Mental Health in Bethesda, Maryland. The articles you are
about to read typ-ify
the high-quality scientific information we wish to provide in this new journal. The
theme of thisissuegeriatric
depressionhas prompted us to reflect on the broader concept of cerebral
aging.Because
of the ongoing significant increase in life expectancy and the larger segment
of the popu-lation
reaching retirement age to enjoy a new period of life, drug regulatory agencies
in most countrieswill
have to consider and approve new treatments for the prevention of aging, particularly
cerebralaging. The
development of drugs for cerebral aging opens up a new area of research, and
with it comesthe
need to address specific clinical and therapeutic issues: Firstly, the
diagnosis of normal and abnormal cerebral aging should become more precise and
reli-able. This
means we need to better understand the phenomenology of aging and refine our qual-itative and quantitative diagnostic
instruments. Secondly, techniques
for investigating the central nervous system should be perfected in order todefine pertinent biological markers
for the early diagnosis and therapeutic follow-up of mild dis-orders related to cerebral aging. Thirdly, clinical
research protocols should be validated to assess the changes achieved by exper-imental treatments for the prevention
of brain aging. These protocols should facilitate the dis-covery of innovative treatments, both
for normal and abnormal cerebral aging.These
issues are all the more pressing, as the benefit of a longer life will be
squandered without thecognitive
and intellectual functions necessary to profit from these extra years. Increased
physicallongevity
should not come at the expense of a pitiful intellectual decline into dotage or
"second child-hood."
The pharmaceutical industry is keenly aware of the human, scientific, and
financial implicationsof
this emerging market. Several companies have endeavored to develop drugs
for the prevention ortreatment
of normal cerebral aging. Unfortunately, these initial efforts have
been stymied by concernson
the part of governmental regulatory agencies about elevated costs and poor cost-benefit
ratios.Cerebral
aging is, in our opinion, one of the major public health issues of our
time, and the increasein
longevity makes it a problem we can no longer afford to ignore. One of the
best means to persuadegovernments
and public opinion that the mental health of the aging population is so important
is to fur-ther
develop our scientific research on this subject.Sincerely
yours,Jean-Paul
MACHER, MDMarc-Antoine
CROCQ, MDE
d i t o r i a lD