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Professor Valery Feigin, AUT University, Director of the National Institute for Stroke & Applied Neuroscience There are already almost 57 million people in the world living with Alzheimer’s disease and/ or other types of dementia, which is more than twice the number we had in 1990, and this number is projected to almost triple to 153 million by 2050. If funding were no object, we could implement proven effective dementia prevention and treatment strategies that could prevent over 40% of dementia cases, or cure it. Some potential breakthroughs are: • Discovery of genetic markers and gene-environment interactions and triggers that determine the development of dementia • Development of reliable, individualised prediction tools •Further discoveries of protective factors against dementia of various types • Gene therapy to prevent and/or treat dementia of various types I hope that: • Discovery of safe medication to cure and/or stop progression of dementia at early stages could happen within the next 10 years • Integrative strategies for primary dementia prevention (including a focus on healthy lifestyle) and action plans on a population level would become mandatory for all governments to have soon Professor Lynette Tippett, Director, Dementia Prevention Research Clinics & CBR Associate Director I see a future where a blood test, in combination with improved methods of clinical assessment, will enable timely and accurate diagnosis of Alzheimer’s disease dementia for all people in Aotearoa. I hope the future will see all people with dementia included as active members of our communities. Diagnostic advances will also be able to identify accurately people at high risk of dementia, but this will pose challenges for many individuals, unless we have disease-altering treatments (drug or lifestyle) available that significantly reduce risk. The more investment we can make in accelerating dementia research, the sooner all elements of this future will arrive, to the benefit of all people and whānau in Aotearoa. Dr Makarena Dudley (Te Rarawa, Te Aupōuri, Ngāti Kahu), CBR Deputy Director Māori I have been researchingmate wareware inMāori since 2015, focusing on the development of a theory of dementia fromaMāori worldview. We have developed a Māori-friendly tool for clinicians for detectingmatewareware as well as theMateWareware app to provide information forMāori whānau (matewareware.co.nz) . In the next 10 years, I would like to seemore services thatmeet the cultural needs ofMāori, including the provision of traditional Māori ways of healing and caring, for whānau livingwithmatewareware. We need to focus on ensuring that dementia support inAotearoameets the diverse cultural needs of all communities. I would like to seewhānau properly resourced and supported so they are able to care for their loved ones according to traditional kaitiakitanga practices. Dr Bruce Mockett, memory expert, University of Otago As a neuroscientist, I’mexcited about what current dementia-related brain research has the potential to deliver in the next decade. There is a significant global effort to address three acute challenges that currently limit our ability to treat conditions likeAlzheimer’s disease. These are the lack of tests for presymptomatic diagnosis, the lack of disease-modifying therapeutics and the need for new technologies that enable the non-invasive delivery of therapeutics from the blood to the brain. Our own Neurological Foundation-funded research is part of this effort, and while there are still significant issues to be resolved, the constant streamof new discoveries fuels my hope for the future. Dr Margaret Ryan, memory expert, University of Otago In the next decade, I anticipate we will gain a thorough understanding of the early molecular changes that lead to Alzheimer’s disease, paving the way for treatments that enhance the brain's protective responses. GP visits will incorporate straightforward routine blood and/or eye-based risk assessments for Alzheimer’s disease. Effective treatments to slow or halt disease progression will be available, along with support for lifestyle changes. The importance of maintaining an active lifestyle and social connections in middle and older age will be widely recognised, leading to an overall healthier older adult population. Headlines 17