Abstract
Neuroimaging and fluid biomarkers have revolutionized the way we define Alzheimer’s disease (AD), identify at-risk individuals, diagnose those with symptoms, and may eventually enable us to treat patients in the earliest stages of the disease. We review advances in imaging the principal pathological hallmarks and functional perturbations in the AD brain and map progress in identifying cerebrospinal fluid and blood biomarkers of AD. Together, these modalities have provided invaluable insights into the evolution of AD decades before the onset of cognitive impairment. While they have been rapidly adopted into clinical settings, the evidence base for this remains contested. However, the clear value of neuroimaging and fluid biomarkers is in their relevance to clinical trials and the recruitment of individuals who perceive themselves to be at sufficiently high risk to warrant joining research studies testing experimental AD treatments. This marks a paradigm shift in our efforts to overcome one of the global public health challenges of our time.
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