Comparison of neuroimaging, cerebrospinal fluid (CSF), and cognitive measures relative to the estimated age of symptom onset in patients with familial Alzheimer's disease (AD). The relative difference between carriers of autosomal dominant AD mutations [mutation carriers (MCs)] and noncarriers (NCs) in neuroimaging, CSF, and cognitive measures at multiple time points prior to and after the estimated age of symptom onset is shown. Measures of amyloid-beta (Aβ) appear to change earliest in MCs relative to NCs, followed by measures of CSF tau, hippocampal atrophy, and glucose hypometabolism. All of the neuroimaging and CSF biomarkers show alterations in MCs relative to NCs before the estimated age of symptom onset. Reproduced from The New England Journal of Medicine, Bateman RJ et al., Clinical and biomarker changes in dominantly inherited Alzheimer's disease, 367, 795–804, © 2012 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. CDR-SOB, Clinical Dementia Rating Scale, Sum of Boxes score.