Background

There is evidence that healthy aging and the development of dementia are continuous processes governed by a close interplay between neurodegenerative and neuroprotective mechanisms.
Therefore there is a subtle line separating healthy aging from dementia. Innovative approaches capable of promoting neuroprotection and slow down neurodegenerative processes to move on towards improved quality­ of ­life at an individual level would be essential to reduce the societal costs of an aging population.
An important step towards this goal is the development of a research tool, and eventually a clinical tool, that can capture the course of both types of mechanisms, at an individual level and early on, before neurodegeneration has gone too far. Important advancements in this direction have been accomplished in the last decade, with significant contributions from the field of neuroimaging. Yet it seems unlikely that any single method can fully assess the nature of both neurodegeneration and neuroprotection. Such a tool must be multi­
faceted and include both structural and functional biomarkers at a high level of detail, yet integrate measures across different brain areas in network analyses. It should also be quantitative so it can be reliably used at different points in time and facilitate multi­centre studies in different ethnic and cultural settings.
The next challenge is to identify actions that can be undertaken in order to promote well­being, even in case that neurodegenerative processes have already begun, like in Mild Cognitive Impairment. Even if no actual
cure can be offered, such actions should prolong the time available before mild symptoms have evolved into
more serious forms of dementia and in any case improve quality­of­life. In the past, research in this direction
has been focused on pharmacological intervention, but audacious steps towards adequate training programs
have recently been undertaken.