Abstract

The notion that a single event might be causative has hampered the search for either a preventative or cure for disturbed cognition. The cellular composition of the brain comprises five cell types: Neurons, microglia, astrocytes, oligodendrocytes and endothelial cells. Successful treatment, whether for prevention or cure of Alzheimer’s Dementia (AD), must address all cell types These cell types may interact with each other to form a complex system, with interdependence, synergy and adaptability; once that system has changed so as to create the emergence of Alzheimer’s Dementia (AD), it may be very difficult and perhaps impossible, to move it backwards to an earlier, preAD state. Therefore, prevention rather than cure should be the goal. Each of three available drugs acts to benefit all five cell types: Fluoxetine, pioglitazone and thiamine. This article describes the actions of each. Two of the drugs given together might be a powerful prophylactic against cognitive loss in persons at risk: Thiamine plus fluoxetine, thiamine plus pioglitazone or fluoxetine plus pioglitazone. Their potential benefit should be tested in a clinical trial.

Keywords: Alzheimer’s dementia; Interdependence; Pioglitazone; Synergy