Perspective on the "2014 Report on the Milestones for the US National Plan to Address Alzheimer's Disease".

The " Report on National Alzheimer's Plan Milestones— FY' 2014 " [1], which appears in the current issue of Alzheimer's & Dementia, provides an overview of progress in Alzheimer's research and " professional judgment " recommendations for specific " new milestones, " as a road map, for implementing the legislative intent of the National Alzheimer's Project Act (NAPA). This report reflects the collective thinking of the Alzheimer's Association's Work-group on Milestones (ALZ-WG), which included key leaders in dementia/Alzheimer's disease research. Public Law (PL 111-375), a.k.a., NAPA—enacted by Congress in 2011, mandated the formulation of a " national strategic plan " to mobilize research and development (R&D) resources, which would alter the catastrophic trajec-tory of an imminent public health crisis due to the exponential increases of people with the disease and explosive costs of health care. The overall strategic goal of the " national plan " is to promote the discovery and validation of wide arrays of new scientific knowledge and associated novel technologies, which would ameliorate the progression of not only Alzheimer's disease but also other chronic brain disorders due to degenerative processes. The ultimate aim of the " national plan " is to expand or develop the national scientific-technical capabilities, which would eventually enable the prevention of the onset of disabling symptoms within a decade. The strategic public health objective of the national plan is based on the premise that a modest delay of 5 years in the onset of symptoms will reduce the prevalence and health care cost of the disease by 50% [2]. A national strategic goal to prevent Alzheimer's disease and other chronic brain disorders within a decade is indeed a difficult challenge; however, such an ambitious mission is no less daunting than the start up of other great " big science " enterprises such as the Human Genome Project. This grand vision accelerating the discovery of interventions is not framed as a promise for disease eradication, but rather, as a national commitment for a decade-long sustained support to mobilize coordinated efforts to focus allocation of funds and resources toward such achievement. 1. What are some of the decisive challenges for a grand " national plan? " The ALZ-WG was convened by the Alzheimer's Association not only to review and evaluate the progress in attaining the objectives of various " milestones " of the national plan but also to recommend " new milestones. " The ALZ-WG …