By Jason Karlawish

It is possible to both have and not have Alzheimer’s disease. Contradictory as this statement is, a study reported from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) supports it.

In a paper published in the October issue of the Annals of Neurology investigators reported the results of biomarker studies of 53 patients with dementia caused by Alzheimer’s disease. They found a notable proportion of these patients lacked one of the signature pathologies: brain amyloid. This result has notable scientific and policy implications.

Since 2004, ADNI, a longitudinal, NIA-industry funded study, has meticulously followed a cohort of persons with normal cognition, mild cognitive impairment, and dementia caused by Alzheimer’s disease. Key measures are biomarkers, a term that describes a measure that captures a complex pathologic process, such as how low density liproprotein (the LDL or “bad” cholesterol) captures the myriad of events leading to heart disease, and if abnormal, prompts a clinician to prescribe treatment.

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