Clinical trials are largely funded by the pharmaceutical industry. Many medical journals continue to devote entire issues to industry sponsored research results, whose consistently positive findings harbinger hope for record sales to large markets. Potential treatments for dementia, which affected some 8% of Canadians aged 65 and over during the 1990s, can well be targeted to the wider diagnostic category of cognitive impairment, affecting 25% of seniors. During the 1990s, as public grants were declining, clinician-researchers were encouraged to meet directly with industry to form university-industry, public-private research partnerships. While evidence mounts that these social relationships are fraught with conflict of interest, the research results are bought special space in key journals and remain largely uncontested. These research results, with carefully designed recruitment strategies, innovative methodological approaches and sophisticated if sometimes enigmatic biostatistical analytical wizardry safely speed these drugs through regulatory approval. This paper overviews the past decade of diagnosing dementia and cognitive impairment, the role of industry driven research, technology assessment and evidence for the changing diagnosis of dementia from a memory to a behavioural syndrome based upon treatment effects.
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