Both 2024 Alzheimer's Criteria Read Variables Outside Their Shared Biomarker Profile
Applied to the same amyloid and tau results, the two 2024 criteria for Alzheimer’s disease place the same cognitively unimpaired, biomarker-positive person on opposite sides of the disease boundary: a patient under the Alzheimer’s Association criteria, a person at risk under the International Working Group criteria. Both accept the amyloid/tau/neurodegeneration profile, and neither rule is a function of it. The Association rule reads which test found the tau; the Working Group rule reads where in the brain the tau sits, which gene the person carries, and whether they have symptoms. Of 1,195 participants scored under four earlier criteria sets, 512 (42.8%) had a discordant diagnosis. Autopsy cannot arbitrate, because each program treats its own standard as the reference.