Researchers Assess the Theoretical Impact of Biomarker Framework on Dementia Prediction

The U.S. National Institute on Aging and the Alzheimer's Association have backed a research tool based on three biomarkers for dementia prediction called the AT(N) framework — A for amyloid, T for tau, and (N) for neurodegeneration — reports News-Medical . New research published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association suggests a subset of people classified by this tool as having the highest risk for dementia will not develop the condition in their lifetime. The investigators used data collected by the Adult Changes in Thought study, which has tracked more than 5,500 older volunteers to identify new cases of dementia, of whom about a third allowed post-mortem studies of their brains. The autopsy results for amyloid, tau, and neurodegeneration were used to approximate AT(N) classification five years prior to death. While 67 percent of volunteers with the proxy A+T+(N)+ profile developed dementia in the next five years, 33 percent did not. If validated with AT(N) biomarkers, these findings imply that any drug trial using the AT(N) framework will demand many more participants to be screened to enroll enough people to realize statistically solid results. "The AT(N) framework is valuable because it places living people on the spectrum of Alzheimer's disease neuropathologic change, which will allow us to better study the concept of resilience to this pathology and encourage the development of additional biomarkers necessary for the accurate prediction of who will go on to develop dementia," concluded the University of Washington's Caitlin Latimer.