Cited by 523Alzheimer's disease research and treatmentsDementia and Cognitive Impairment ResearchNeuroinflammation and Neurodegeneration Mechanisms

Inconsistencies and Controversies Surrounding the Amyloid Hypothesis of Alzheimer's Disease

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Morris, Gary P, Clark, Ian A, Vissel, Bryce·2014·Acta Neuropathologica Communications

Abstract

The amyloid hypothesis has driven drug development strategies for Alzheimer's disease for over 20 years. We review why accumulation of amyloid-beta (Aβ) oligomers is generally considered causal for synaptic loss and neurodegeneration in AD. We elaborate on and update arguments for and against the amyloid hypothesis with new data and interpretations, and consider why the amyloid hypothesis may be failing therapeutically. We note several unresolved issues in the field including the presence of Aβ deposition in cognitively normal individuals, the weak correlation between plaque load and cognition, questions regarding the biochemical nature, presence and role of Aβ oligomeric assemblies in vivo, the bias of pre-clinical AD models toward the amyloid hypothesis and the poorly explained pathological heterogeneity and comorbidities associated with AD. We also illustrate how extensive data cited in support of the amyloid hypothesis, including genetic links to disease, can be interpreted independently of a role for Aβ in AD. We conclude it is essential to expand our view of pathogenesis beyond Aβ and tau pathology and suggest several future directions for AD research, which we argue will be critical to understanding AD pathogenesis.

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  • There is a lack of correlation between plaque load and cognitive decline in AD patients.

    “along with the lack of correlation between plaque load and cognitive decline in AD patients3”

    From Amyloid-β induces lipid droplet-mediated microglial dysfunction via the enzyme DGAT2 in Alzheimer’s disease (2025) · cites this paper as [3]

    In “The Aβ deposition paradox,” the paper says amyloid deposits do not correlate well with cognitive impairment and notes that cognition can decline after amyloid deposition plateaus. Its Figure 3 describes a weak correlation between plaque load and cognition, rather than no correlation at all; the claim overstates that distinction. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Authors
Morris, G. P., Clark, I. A., & Vissel, B.
Affiliations
  • Garvan Institute of Medical Research (AU)
  • Australian National University (AU)
Corresponding author
Vissel, Bryce
Venue
Acta Neuropathologica Communications
Published
2014-09-18
Volume
2
Issue
1
Pages
135-135
ISSN
2051-5960 (ISSN-L)
OpenAlex
W2148020885
Cited by
522
References
218
Citations by year
2026: 13 · 2025: 44 · 2024: 47 · 2023: 47 · 2022: 42 · 2021: 41 · 2020: 48 · 2019: 59 · 2018: 63 · 2017: 46 · 2016: 49 · 2015: 22 · 2014: 1
FWCI
26.23
Type
journal article
Language
en
Open access
Locations
  • Acta Neuropathologica Communications (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ANU Open Research (Australian National University) (submittedVersion, cc-by)
  • UTS ePRESS (University of Technology Sydney) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
Keywords
amyloid hypothesis, Alzheimer's disease, amyloid-beta oligomers, amyloid plaques, synaptic loss, neurodegeneration, cognitively normal individuals, genetic risk factors, tau pathology, pathological heterogeneity, comorbidities, Alzheimer's disease pathogenesis
MeSH terms
Alzheimer Disease, Humans, Synapses, Amyloid beta-Peptides, Neurofibrillary Tangles, tau Proteins, Plaque, Amyloid

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