Reducing misdiagnosis of Alzheimer’s Disease pathology utilizing CSF and amyloid PET

Utilizing cognitive tests alone, including the Mini‐Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), cannot detect the presence of amyloid plaques and tangles in Alzheimer’s disease (AD). While in late stages of AD clinical diagnosis relying primarily on cognitive testing is correct 70‐90% of the time, in MCI accuracy is reduced to 50‐60%. Although autopsy is the gold standard for AD diagnosis, amyloid PET imaging and more recently the Lumipulse Gβ‐Amyloid Ratio (Aβ1‐42/Aβ1‐40) are validated to determine amyloid pathology. With the upcoming availability of disease modifying therapies targeting amyloid in MCI and early AD, and anti‐tau drugs in the pipeline, it is necessary to have true measures of AD pathology for a clinical evaluation early in the disease process. Here we examine the performance of cognitive testing alone for identification of amyloid positivity in MCI patients from the ADNI study when compared to amyloid PET and CSF testing.