The challenging concept of preclinical Alzheimer's disease.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic methodology or new empirical data
PubMed 41238317 · doi:10.1016/j.neurol.2025.07.016
What was done
This narrative review synthesized current literature on preclinical Alzheimer's disease (AD), covering biomarker cascades (amyloid, tau, and neurodegeneration), prevention clinical trials, prognostic modeling, and societal/ethical implications. It critically contrasted the two primary research diagnostic frameworks used to define preclinical AD and classify patients.
What was found
The abstract reports no quantitative metrics or empirical statistics. It notes conceptually that AD develops over decades prior to symptom onset and that defining this preclinical phase is marked by unresolved challenges in diagnostic boundaries, accurate prognostic modeling, trial design, and clinical efficacy of disease-modifying therapies.
Why it matters
Early intervention is considered critical for halting AD progression, but inconsistent research definitions and uncertain biomarker prognoses complicate the selection of candidates for preventive therapies.
Limits
This is a narrative review without systematic search protocols, quantitative data synthesis, or quality appraisal of cited literature. It provides no original participant data or statistical effect estimates.
Cited by
- supports The development of the three major categories of age-related diseases—most cancers, cardiovascular disease, and neurodegenerative disease—takes more than 20 years before clinical manifestation.