New insights into atypical Alzheimer's disease in the era of biomarkers

Most patients with Alzheimer's disease present with amnestic problems; however, a substantial proportion, overrepresented in young-onset cases, have atypical phenotypes including predominant visual, language, executive, behavioural, or motor dysfunction. In the past, these individuals often received a late diagnosis; however, availability of CSF and PET biomarkers of Alzheimer's disease pathologies and incorporation of atypical forms ofAlzheimer's disease into new diagnostic criteria increasingly allows them to be more confidently diagnosed early in their illness. This early diagnosis in turn allows patients to be offered tailored information, appropriate care and support, and individualised treatment plans. These advances will provide improved access to clinical trials, which often exclude atypical phenotypes. Research into atypical Alzheiiner's disease has revealed previously unrecognised neuropathological heterogeneity across the Alzheimer's disease spectrum. Neuroimaging, genetic, biomarker, and basic science studies are providing key insights into the factors that might drive selective vulnerability of differing brain networks, with potential mechanistic implications for understanding typical late-onset Alzheimer's disease.

Automated summary

Most Alzheimer's disease patients present with memory problems, but a significant proportion of young-onset cases exhibit atypical symptoms like visual, language, executive, behavioral, or motor issues. With advancements in biomarkers and new diagnostic criteria, early detection and tailored treatment plans are now becoming more accessible for these individuals, offering them better care and support. Research into atypical Alzheimer's has unveiled diverse neuropathology across the disease spectrum, providing insights into the vulnerability of different brain networks and potentially impacting understanding of typical late-onset Alzheimer's disease.