Pathologic correlates of nondemented aging, mild cognitive impairment, andearly-stage Alzheimer's disease

The results of studies from the Washington University Alzheimer Disease (AD ) Research Center and those from other centers and investigators regarding the neuropathologic correlates of normal aging and early-stage AD are revie wed. We conclude that widespread amyloid plaques in the neocortex best dist inguishes very early stage AD, including "MCI" stage, and preclinical stage s, from healthy brain aging. Other AD lesions, including increased formatio n of neurofibrillary tangles and neuronal degeneration appear to result fro m the amyloid-initiated pathologic process, although they may have a more i mmediate effect on expression and severity of dementia. These data provide strong support for anti-amyloid intervention as a preventive therapy for AD . It is now critical to develop methods to detect preclinical AD during lif e.