The rate at which the protein beta-amyloid accumulates into the sticky plaques associated with Alzheimer’s disease (AD) is already slowing by the time a patient would be considered to have preclinical AD, according to a longitudinal study of healthy adults published in JNeurosci. The research suggests that anti-amyloid therapies would be most effective before individuals reach the threshold for preclinical AD, long before the first signs of memory issues.

Determining how early to intervene is a central challenge in slowing the progression of AD. Clinical trials of drugs for lowering amyloid levels typically involve individuals who do not yet have symptoms but are considered “amyloid positive” and at risk for developing AD. These trials have been largely unsuccessful, perhaps because they begin too late.

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