Disentangling risk of progression and clinical trajectories in preclinical AD: views from the International Working Group

The IWG framework bridges biomarker research and clinical outcomes, advancing preclinical AD understanding. By distinguishing "asymptomatic at risk" from "presymptomatic AD," it fosters biomarker innovation, refines risk stratification, and promotes tailored therapeutic strategies. This framework advances the EuroPAD community's goals, emphasizing the need for individualized interventions and aligning research priorities with clinical and public health imperatives. References: 1 Dubois B, Villain N, Schneider L, et al. Alzheimer Disease as a Clinical-Biological Construct-An International Working Group Recommendation. JAMA Neurol 2024. 2 Jack CR, Andrews JS, Beach TG, et al. Revised criteria for diagnosis and staging of Alzheimer's disease: Alzheimer's Association Workgroup. Alzheimers Dement 2024; : 1-27. 3 Brookmeyer R, Abdalla N. Estimation of lifetime risks of Alzheimer's disease dementia using biomarkers for preclinical disease. Alzheimer's and Dementia 2018; 14: 981-8. 4 Ossenkoppele R, Pichet Binette A, Groot C, et al. Amyloid and tau PET-positive cognitively unimpaired individuals are at high risk for future cognitive decline. Nat Med 2022; 28: 2381-7.