Alexis Moscoso, PhD, University of Gothenburg, Gothenburg, Sweden, shares an overview of his work looking into the time interval between amyloid- and tau-PET positivity in Alzheimer’s disease. In the preclinical stage of disease, individuals will undergo a transition from amyloid (A)-positive, tau (T)-negative, to A+T+. This change to full AD neuropathology is associated with a substantial risk of clinical progression. To better understand the clinical relevance of the A+T- stage, Dr Moscoso used longitudinal amyloid- and tau-PET data to estimate the time gap between amyloid- and tau-positivity, and the factors that influenced this gap. While highly variable across individuals, the estimated time gap was 9 years. The presence of cognitive impairment was found to accelerate the onset of tau positivity (median tau-free survival difference ~6 years). These data have implications for Alzheimer’s disease prevention trials, as they suggest that a substantial proportion of A+T- cognitively unimpaired older individuals will not develop tau pathology and subsequent symptoms in their lifetime. Therefore, it is important to select A+T+ individuals for prevention trials as they are the most likely to benefit from disease-modifying therapies. This interview took place at the Alzheimer's Association International Conference® (AAIC) 2023 in Amsterdam, Netherlands.
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