Broadening the scope of epidemiologic dementia research

Excerpt

In this issue of EJE, Glymour and colleagues point out several shortcomings of the recently proposed NIA-AA framework of research criteria for diagnosing Alzheimer’s disease, in which Alzheimer’s disease is defined solely as a constellation of abnormal β-amyloid and pathologic tau deposits (Table 1) [1]. Glymour and colleagues emphasize that it remains uncertain whether β-amyloid causes Alzheimer’s disease, focusing specifically on the failure of numerous anti-amyloid trials, the observation that most individuals with cerebral β-amyloid plaques do not develop dementia (indicating low specificity for dementia), and the finding that there is no (or limited) evidence for β-amyloid in approximately one-quarter of individuals who meet clinical criteria for Alzheimer’s disease dementia (indicating low sensitivity). The authors further argue that it is unclear whether β-amyloid and tau reflect the most relevant biological processes leading to Alzheimer’s disease dementia. …