Core Concepts
Biomarker changes in Alzheimer's disease can be detected up to 20 years before clinical diagnosis.
Abstract
The study conducted over 20 years focused on tracking biomarker changes in adults with Alzheimer's disease (AD) compared to those without the disease. Key findings include:
Changes in amyloid-beta 42 (Aβ42), phosphorylated tau 181 (p-tau181), and neurofilament light chain (NfL) levels were monitored.
Aβ42 levels diverged 18 years before clinical signs, p-tau181 increased 11 years before onset, and NfL levels rose 9 years before diagnosis.
These changes were followed by hippocampal atrophy and cognitive decline.
The study highlights an accelerated change in CSF biomarkers before diagnosis.
The research emphasizes the importance of understanding the physiological events preceding AD for prevention and treatment strategies.
Ethnic variations in biomarkers were noted, suggesting the need for inclusive studies across different populations.
Stats
Levels of (Aβ42) in CSF and the ratio of Aβ42 to Aβ40 in people who developed AD diverged from those of peers who remained cognitively normal at 18 years and 14 years, respectively, before clinical signs of disease appeared.
The level of p-tau181 in CSF increased 11 years before disease onset, and NfL levels, a measure of neurodegeneration, increased 9 years before diagnosis.
Quotes
"The importance of this work cannot be overstated. Knowledge of the timing of these physiological events is critical to provide clinicians with useful starting points for prevention and therapeutic strategies." - Richard Mayeux, MD