Preclinical Alzheimer's or asymptomatic at-risk?

Abstract

In the latest NIA-AA criteria, AD diagnosis is centered exclusively around a biomarker definition of disease according to ATN status. This proposal moved AD to a purely biological condition dissociated from a clinical phenotype. However, evidence suggest that the presence of tau and amyloid positivity is insufficient to definitively predict the invariable occurrence of symptoms or progression to dementia in those without clinical findings. Longitudinal molecular neuro-imaging studies are also inconsistent in predicting a reliable outcome at an individual level for those who are amyloid and tau positive and cognitively unimpaired, even after long-term follow-up.