In the last years advances in our knowledge and understanding of dementia have proceeded at a truly breathtaking pace. However, we cannot be complacent and there is still a long way to go. We are expecting a huge increase in dementia cases over the next 30 years, specially in the developing world. The socioeconomic burden of dementia remains enormous and will continue to increase, particularly in countries, such as Spain, with a low rate of fertility. We still lack sufficiently accurate "in vivo" diagnostic markers to replace the "gold standard" of neuropathology. We need to learn more about aetiological factors and the neurobiological mechanisms that cause neuronal loss remain elusive. Current therapeutic approaches remain limited and effective disease-modifying and preventive strategies still have to be determined. Despite progress, services in many countries remain underdeveloped and too fragmented to cope with the increase in cases which lie ahead. Dementia is one of the major challenges facing mankind in the new millenium, given the unmet needs ahead of us.
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