A Call for Improving Clinical and Cognitive Assessments to Reduce the Gap Between Amyloid/Tau Pathology Onset and Detection of Cognitive Dysfunction

In this commentary, we discuss the new perspectives on the definition and criteria for Alzheimer's disease, particularly in relation to the biological and clinical-biological approaches. We argue that research must continue to focus on improving clinical and cognitive tools to contextualize biomarker findings and understand the clinical implications of different pathophysiological processes at the individual level. We propose several solutions, including the development of "cognitive stress tests," digital clinical biomarkers, innovative analytical procedures, more refined studies for collecting rigorous and longitudinal normative data, and, ultimately, enhanced clinical skills. Overall, these strategies could help "shorten" the preclinical period and bridge the gap between the biological and clinical-biological approaches by aligning biomarker abnormalities with the onset of cognitive dysfunction more effectively.