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Seventeen of 21 participants with initially elevated A\u03b2 deposition demonstrated subsequent A\u03b2 plaque growth (approximately 8.0% per year), and none reverted to a state of no A\u03b2 deposits. Ten individuals converted from negative to positive PiB status, based on a threshold of the mean cortical binding potential, representing a conversion rate of 3.1% per year. Individuals with an \u03b54 allele of apolipoprotein E demonstrated increased incidence of conversion (7.0% per year). Our findings suggest that the major growth in A\u03b2 burden occurs during a preclinical stage of Alzheimer disease (AD), prior to the onset of AD\u2010related symptoms. 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