Alzheimer's disease, senile dementia, atherosclerosis, senile dementia of the Alzheimer's
type, NINCDS-ADRDA probable Alzheimer's disease, IWG prodromal Alzheimer's disease,
NIA-AA preclinical Alzheimer's disease, IWG2 at risk for Alzheimer's disease… This
disease has been in dynamic re-definition for the past 115 years. Biomarkers of AD
pathology have allowed to perform an “in vivo neuropathology” and demonstrate the
presence of brain pathology long before any sign of cognitive deterioration, and possibly
even in persons who will never develop cognitive deterioration. In persons with cognitive
impairment, this has provided the unprecedented opportunity of an accurate molecular
diagnosis and paved the way to personalised pathology-based interventions. In persons
with no cognitive impairment, the detection of pathology is not accompanied by the
prediction of when, and even if, cognitive impairment will develop. This uncertainty
must be sorted out for biomarkers to be used appropriately and safely in this population
and for the very concept of Alzheimer's disease to be fleshed out once and for all.
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