oa Editorial (Thematic Issue: Disease Control and Active and Healthy Ageing: New Paradigms of Therapeutic Strategy)

Worldwide, the percentage of people aged over 60 years is growing up quicker than any other age group, as a result of both longer life expectancy and declining birth rates as well as a success of the public health policies and the socioeconomic development. The World Health Organization (WHO) has been pointed out recently that: “currently, one in every nine people in the world is 60 years of age or older. This is expected to increase to one in five people by 2050”. This success (the transition to a much older population) is a challenge for the modern society that shall maximize the health and the functional ability of older people as well as their social participation and safety to achieve an “active ageing”. “Health” refers to physical, mental and social well being as expressed in the WHO definition of health: “maintaining autonomy and independence for the older people is a key goal in the policy framework for active ageing”. “Active” refers to “continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force”. In this issue Alzetta et al. (University of Genoa, Italy) reviews the grounds and patterns of the structuring of longevity and ageing in our society [1]. The older people, even in poor countries, die of non-communicable diseases (NCDs), such as heart disease, cancer or diabetes, rather than of infectious or parasitic diseases. On 2010, the UN General Assembly passed the resolution A/RES/64/265NCD recognizing “the enormous human suffering, premature death and the seriously negative socioeconomic impact caused by the growing burden of NCD” and called for “global and national action at the highest level to address this development issue”. In this special issue Bousquet et al. (Inserm, France) review the complexity of NCDs intertwined with ageing, show an overview of the problem and propose practical examples of System Medicine (SM) applied to NCDs [2]. Moreover, Cesario et al. (IRCCS “San Raffaele Pisana”, Italy) review the novel system approaches to NCDs, discuss the passage from System Biology (SM) to SM and present the scientific and clinical background of a SM platform [3]. In this issue different pathologies, clinical conditions and pharmacological approaches are reviewed considering the role of ageing. Mazzucco et al. (Catholic University, Italy) review breast cancer in various age-groups and the response to Trastuzumab, a monoclonal antibody that interferes with the HER2/neu receptor [4]. Piotrowicz et al. (Jagiellonian University, Poland) review the pharmacological management of hypertension [5], Matera et al. (Second University of Naples) propose new treatment for chronic obstructive pulmonary disease (COPD) [6], and Zanandrea et al. (University of Toulose, France) review the treatment of sarcopenia [7]. As the population ages, the burden of neurodegenerative disorders, including Alzheimer disease (AD), will increase creating an unsustainable healthcare challenge due to a lack of effective treatment. In this issue Hasnain and Vieweg (Memorial University of Newfoundland, Canada) overview the vascular risk factors in AD and vascular dementia [8]. AD is characterized by disturbance of various high pre- and cortical functions. Cholinergic projections innervate the prefrontal cortex and reduced cholinergic function is associated with cognitive deficits. Cholinergic neurons are specific neurons that synthesize and release acetylcholine (ACh). ACh acts at nicotinic receptors (nAChR) and muscarinic receptors (mAChR). U.S. Food and Drug Administration (FDA) and The European Medicines Agency (EMA) approved several prescription drugs to treat people who have been diagnosed with AD. The drugs include: Razadyne® (galantamine), Exelon® (rivastigmine), and Aricept® (donepezil). These drugs target acetylcholinesterase (defined acetylcholinesterase inhibitors: AChEI) and, in principle, elevate cholinergic signaling. Another drug is known as Namenda® (Memantine), an N-methyl D-aspartate (NMDA) antagonist. None of these medications stops the disease itself: they help to maintain thinking, memory, and speaking skills but don’t influence the disease’ progression. Unfortunately these drugs are effective only for some patients, and may help only for a limited period of time. In this issue different authors describe new pharmacological approaches to neurodegenerative diseases beyond AChEI. Russo et al. (IRCCS “San Raffaele Pisana”, Italy) in this issue describe the neurobiology of the