"Ultimately, to make a real impact, we have to focus on prevention," says Dr. James Galvin, professor of neurology and psychiatry at New York University Langone School of Medicine. "This means identifying markers of disease to initiate effective treatments before symptoms begin. Waiting until someone already has memory loss suggests that there is already substantial damage to vital brain systems."
Some experts, however, were more skeptical of the editorial's message. Specifically, they question whether amyloid is really the true or only culprit behind Alzheimer's -- and whether focusing on it so heavily may close the door too early on exploring other potential factors behind the disease.
"The danger is that if we rely only on the amyloid hypothesis for developing treatment, we might miss other opportunities," says Dr. Zaven Khachaturian, president of the Prevent AD 2020 Campaign.
Dr. Peter Whitehouse, professor of neurology at Case Western Reserve University School of Medicine, says recent research "should be the proverbial nail in the amyloid coffin," but that the debate will likely continue -- "because there is too much fear and false hope," he says.
Others point out that while inherited Alzheimer's may be associated with amyloid, other cases may not be. Thus, they argue, this research's potential for prevention may be less relevant to the general population.
"It is not clear that this model is the best for sporadic disease," says Dr. Mary Sano, director of Alzheimer's research at Mount Sinai School of Medicine. "There is significant evidence that, in the very old, amyloid burden can exist without symptoms."
Sano adds, "Early, or lifelong, treatment is only warranted with very safe medications, few of which exist."
If such a drug existed, "I'd be standing in line the day the drug store opened with it," says Demarco. "If I am predisposed to Alzheimer's disease, my personal goal would be to prevent it as long as possible."