Predicting Alzheimer’s dementia in oldest of the old

December 27, 2023- A new UPMC study indicates that severity of amyloid deposition in the brain — not just age — may be key to determining who will benefit from new anti-amyloid therapies to delay the progression of Alzheimer’s disease. 

University of Pittsburgh clinicians and scientists report that the accumulation of toxic amyloid beta clumps that signal Alzheimer’s disease pathology accelerates in old age but the baseline amyloid burden and the overall brain health going into this acceleration are more powerful predictors of who is most likely to progress to Alzheimer’s. The paper was published today in Neurology, the medical journal of the American Academy of Neurology.

The presence and the overall quantity and distribution of amyloid beta, or A-beta, clumps in the brain are some of the most common neuropathologies associated with Alzheimer’s. Yet, while people who are 80 and older have the highest prevalence of Alzheimer’s-associated dementias, most studies that measured A-beta burden in the brain using imaging techniques have focused on younger populations.

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