CONy 2022 | The validity of the amyloid cascade hypothesis of Alzheimer’s disease

The Alzheimer’s disease (AD) space has seen a continued debate on the validity of the amyloid cascade hypothesis. Johannes Levin, MD, Ludwig-Maximilians-Universität München, Munich, Germany, discusses the amyloid cascade hypothesis of AD. There is an abundance of research concerning the sequence of events leading to the clinical manifestation of AD: the accumulation of β-amyloid is the earliest event in AD pathogenesis, followed by the accumulation of tau. It is also well-known that β-amyloid alone is insufficient to produce the AD pathophysiologic process, and other processes must be involved. However, the role of β-amyloid in AD pathogenesis is evident. Prof. Levin recognizes that aspects of the cascade processes are poorly understood – particularly the connection between some of the events observed. Therefore, understanding the evolution from β-amyloid pathology in asymptomatic individuals to the tau pathology, typically associated with clinical symptoms, would allow for a full picture of the cascade. Overall, more studies and clinical trials are required to fully understand the sequence of events and causal relationship between β-amyloid and tau. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.