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Preclinical research indicates that various drugs approved for indications such as hypertension and diabetes could also have potentially beneficial effects in Alzheimer's disease, and for some drugs the evidence is also supported by epidemiological data or preliminary clinical trials. This article presents a formal consensus evaluation of these drug repositioning opportunities, and highlights several compounds for which sufficient evidence is available to encourage further investigation and potential progression to clinical trials in Alzheimer's disease.

Agitation and aggression are common symptoms of Alzheimer disease (AD), causing risk and distress to the patient and others. Atypical antipsychotics are the most widely prescribed pharmacological treatments for these symptoms, but they can cause harmful effects. Here, Clive Ballard and colleagues review the risks associated with atypical antipsychotics and present the many alternative treatments and approaches that are available for managing agitation and aggression in AD.

Pain is a frequent complication that is experienced by elderly individuals, including those with dementia. Corbett et al. highlight how pain might represent an unmet need in patients with cognitive impairment and review the best available evidence for tools and interventions to assess and treat pain in the context of dementia.

A recent study has examined potential predictive markers of Alzheimer disease (AD) and stroke. The results challenge some current assumptions, suggesting that stroke might often follow a decade of deterioration in brain structure and function, and that cognitive and MRI markers of AD differ in older and younger individuals.

New EFNS–ENS guidelines provide a broad and comprehensive overview of the literature and key recommendations regarding treatment and diagnosis across a vast range of conditions associated with dementia, with the exception of Alzheimer disease, which was deliberately excluded. Although excellent, the breadth and brevity of the guidelines lead to some important omissions.

Using genome-wide meta-analyses of clinical measures of depression and biobank data, the authors investigate symptom-specific genetic associations between depression and subsequent risk for Alzheimer’s disease, finding an absence of a putative genetic overlap between disorders.

The publication of a consensus definition of Parkinson disease (PD) psychosis in 2007 led to a rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. The authors review this literature and discuss the evolving view of PD psychosis, from distinct classes of symptoms to a continuum progressing over the course of PD.

Millions of pounds per year are spent on various 'brain-training' programs; however, the efficacy and performance of these training regimes is still unclear. In collaboration with the BBC, a six-week online study of brain training was conducted. Although improvements were observed in the specific tasks used for training, in the authors' view there was no evidence that these improvements transferred to other untrained cognitive tasks.

Psychiatric symptoms are frequently observed in patients with Alzheimer's disease or other dementias. Ballard and Howard discuss the current knowledge, and present an analysis of the efficacy of neuroleptic drugs in treating these symptoms and their adverse effects.

Tracking data from 17 marine predator species in the Southern Ocean are used to identify Areas of Ecological Significance, the protection of which could help to mitigate increasing pressures on Southern Ocean ecosystems.

Clinical trials are required to ensure new treatments are safe and effective for patients. The involvement of participants in the planning and execution of clinical trials is critical not only to their success but also so that the participating communities can benefit from them.

Depression is a common symptom in patients with Parkinson disease (PD), and is found at higher rates in these individuals than in healthy populations or patients with other neurodegenerative disorders. Aarsland et al. discuss both the course of depression and the mechanisms that may contribute to the enhanced susceptibility to depression in patients with PD. Management strategies to control depression in these individuals are also highlighted.

Drug repositioning and repurposing can enhance traditional drug development efforts and could accelerate the identification of new treatments. In this Review, Ballard and colleagues highlight priority compounds for repurposing for the treatment of Alzheimer disease.

Openshaw and colleagues find myeloid inflammation and complement activation signatures in patients with long COVID who were previously hospitalized.

Psychosis is a common symptom of Alzheimer disease (AD) and few treatments are available. In this Review, the authors describe the main features of psychosis in AD and other dementias and consider how recent mechanistic insights are informing new treatment approaches.

Dementia is commonly encountered in advanced stages of Parkinson disease (PD), but evidence is accumulating that cognitive decline can manifest much earlier in the disease course. Aarsland and colleagues review current knowledge regarding cognitive impairment in patients with PD, focusing on cerebrospinal fluid and imaging biomarkers as potential predictors of cognitive decline in this population.

Cognitive impairment is common in patients with Parkinson disease and ranges in severity. This Primer reviews the epidemiology, pathophysiology, diagnosis and treatment of cognitive impairment in Parkinson disease and describes the effects on patient quality of life and the future outlook for the field.

Most research into blood-based biomarkers for neurodegenerative disorders has so far focused on Alzheimer disease. In this Review, Aarsland and colleagues give an overview of the current status of blood-based biomarkers for the non-Alzheimer disease neurodegenerative disorders.