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This \u201cbiomarker\u2010based\u201d diagnosis may allow clinicians novel opportunities to use interventions that either delay the onset or slow the progression of cognitive decline, but it will also bring novel challenges. How will changing the definition of AD from a clinical to a biomarker construct change the experience of living with the disease? Knowledge of AD biomarker status can affect how individuals feel about themselves (internalized stigma) and how others judge them (public stigma). Following a review of AD stigma, we appraise how advances in diagnosis may enable or interrupt its transfer from clinical to preclinical stages and then explore conceptual and pragmatic challenges to addressing stigma in routine care.<\/jats:p>","DOI":"10.1016\/j.dadm.2018.02.006","type":"journal-article","created":{"date-parts":[[2018,3,19]],"date-time":"2018-03-19T10:38:20Z","timestamp":1521455900000},"page":"285-300","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Advances in Alzheimer's imaging are changing the experience of Alzheimer's disease"],"prefix":"10.1002","volume":"10","author":[{"given":"Shana D.","family":"Stites","sequence":"first","affiliation":[{"name":"Department of Medical Ethics and Health Policy Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Milne","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care Institute of Public Health, University of Cambridge School of Clinical Medicine Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Karlawish","sequence":"additional","affiliation":[{"name":"Department of Medical Ethics and Health Policy Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,19]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Stigma; Notes on the Management of Spoiled Identity","author":"Goffman E.","year":"1963"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9566.2009.01161.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-soc-071312-145702"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/sw\/52.1.31"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2217\/ahe.12.42"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0144686X10000693"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2016.1255847"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.876"},{"key":"e_1_2_8_10_1","first-page":"228fs13","article-title":"The A4 study: stopping AD before symptoms begin?","volume":"228","author":"Sperling R.A.","year":"2014","journal-title":"Sci Transl Med"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.soc.27.1.363"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-4276-5_25"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6612.2006.00153.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2009.04.198"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732309358330"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.12.045"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.08.031"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/WAD.0b013e3181f32594"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3928\/19404921-20090401-04"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9566.2012.01481.x"},{"key":"e_1_2_8_21_1","volume-title":"No Aging in India: Alzheimer's, The Bad Family, and Other Modern Things","author":"Cohen L.","year":"2000"},{"key":"e_1_2_8_22_1","volume-title":"World Alzheimer Report 2012, Overcoming the Stigma of Dementia","author":"Batsch N.L.","year":"2012"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.55.5.738"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301147"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10823-008-9075-5"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.82.6.878"},{"key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/153331750201700206","article-title":"Awareness of ageism, motivation, and countertransference in the care of elders with Alzheimer's disease","volume":"17","author":"Kane M.N.","year":"2002","journal-title":"Am J Alzheimers Dis Other Demen"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.4065\/81.3.300"},{"key":"e_1_2_8_29_1","unstructured":"Handbook of Mental Health and Aging\u20132nd Edition 1992. 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