Defining patient-centered amyloid PET thresholds for the onset of tauopathy in Alzheimer’s disease

Published in Alzheimer's & Dementia, 2026 (Online Early View), 2026

This comprehensive study addresses a critical challenge in Alzheimer’s disease (AD) staging by developing patient-centered amyloid PET thresholds that signify the onset of significant tau pathology. Analyzing large-scale neuroimaging and clinical data, the researchers found that the trajectory of the amyloid-to-tauopathy transition is significantly modulated by individual factors like age and sex.

Key Findings:

  • Sex Differences: Women were found to reach the threshold for tauopathy onset at lower levels of amyloid PET signal compared to men.
  • Age Effect: Among men, younger individuals exhibited a faster amyloid-associated increase in tau PET signal than their older counterparts.
  • Prognostic Value: Crossing these newly defined thresholds was associated with more aggressive subsequent tau deposition and accelerated cognitive decline.

The results strongly support the need for personalized diagnostic and prognostic models in AD, emphasizing that a one-size-fits-all amyloid positivity cut-off may be insufficient for predicting an individual’s progression to tauopathy.

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Recommended citation: Zhu, Z., Steward, A., Dehsarvi, A., Roemer-Cassiano, S. N., Dewenter, A., Hirsch, F., Frontzkowski, L., Pescoller, J., Klonowski, M., Gnörich, J., Pontecorvo, M. J., Shcherbinin, S., Schöll, M., Buckley, R., Ossenkoppele, R., van der Flier, W. M., & Franzmeier, N. (2026). Defining patient-centered amyloid PET thresholds for the onset of tauopathy in Alzheimer’s disease. Alzheimer’s & Dementia. https://doi.org/10.1002/alz.71064

Recommended citation: Zhu, Z., Steward, A., Dehsarvi, A., Roemer-Cassiano, S. N., Dewenter, A., Hirsch, F., Frontzkowski, L., Pescoller, J., Klonowski, M., Gnörich, J., Pontecorvo, M. J., Shcherbinin, S., Schöll, M., Buckley, R., Ossenkoppele, R., van der Flier, W. M., & Franzmeier, N. (2026). Defining patient-centered amyloid PET thresholds for the onset of tauopathy in Alzheimer's disease. Alzheimer's & Dementia. https://doi.org/10.1002/alz.71064
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