Sanchez-Juan, P., Seshadri, S. September 3, 2017

Despite many disappointments, the strongest current in Alzheimer disease (AD) research remains the pursuit of anti-amyloid therapies. There is increasing recognition that if these compounds are to be effective, early initiation of treatment, before there is irreversible neuronal and synaptic loss, is more likely to be successful. Due to the complexity of AD, to assess individual risk we might need algorithms including multiple variables like age, APOE plus other genetic variants, clinical and neuropsychological information, vascular, metabolic, and lifestyle risk factors, comorbidities, and disease biomarkers. The earliest relatively specific AD biomarker that we currently know of is brain accumulation of β-amyloid (Aβ), which we can observe with amyloid PET scans or by detecting a decrease in CSF Aβ levels.1 PET amyloid tracers have been a major step forward in the field of AD biomarkers, allowing for the first time in vivo visualization of brain fibrillary amyloid.2 Imaging markers of brain amyloidosis have been strongly associated with brain atrophy, cognitive impairment, and subsequent clinical dementia.3

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