The development of DMT for dementia continues to be a struggle, but with the development of new biomarkers and innovations in clinical trials, including new endpoints, the ray of hope is gradually beginning to appear. From a pathomechanistic point of view, anti-amyloid therapy should still be the first line of defense, but the length of the preclinical course and the health economic perspective suggest that anti-tau therapy will become increasingly important in the future. In addition, if these molecularly-targeted therapies show some trend towards improvement, even if it does not lead to a significant difference in the endpoints, this will provide proof of concept for molecularly-targeted therapies for amyloid and tau, and may provide impetus for the development or redevelopment of many small molecules known to act on these substances. The development of disease-modifying drugs to prevent and treat dementia is still a long way off, and there is no time to spare for the explosive increase in the number of people with dementia. Meta-analyses of various large epidemiological studies have reported a reduction in AD by suppressing AD risk factors and promoting protective factors. The steady practice of treating and managing these risk factors for AD, such as hypertension, diabetes and obesity, cannot be ignored in the actual practice of AD prevention and treatment.