Decades ago, dementia was generally regarded as a natural consequence of the ageing process, but pivotal scientific discoveries made in the past 20 years are altering this perspective. With much still to understand about the complex changes in brain mechanisms that occur in people with dementia, and the recent discovery of biomarkers for diagnosis and prognosis, the need for more research funding is urgent. Udani Samarasekera investigates new initiatives in the field.