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We now characterize cross\u2010sectional A\u03b2 plaque, tau tangle, and cortical atrophy (neurodegeneration) measurements, classifications, and associations with age in a larger number of unimpaired HMs, HTs, and NCs over a wider age range.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed <jats:sup>11<\/jats:sup>C Pittsburgh compound B (A\u03b2) positron emission tomography (PET), flortaucipir (tau) PET, and volumetric magnetic resonance imaging data from 164 study participants of age 47\u201386 years, including 26 <jats:italic>APOE \u03b54<\/jats:italic> HMs, 48 HTs, and 90 NCs matched for age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A\u03b2 PET measurements rose, plateaued at the respective ages of 68 and 76, and then declined with age in unimpaired HM and HT groups. Compared with NCs, these two groups began to have significantly higher A\u03b2 PET measurements at ages 62 and 70, respectively, and no longer had significantly higher measurements by ages 71 and 78, respectively. They began to have significantly higher entorhinal cortex tau PET measurements at ages 66 and 70, respectively, and no longer had significantly higher measurements by ages 74 and 78, respectively. Brain atrophy measurements tended to decline slowly with age in all three genetic groups. Their elevated tau PET measurements were attributable to those with positive A\u03b2 PET scans. 41.0%, 18.0%, and 5.0% of the 47\u2010 to 70\u2010year\u2010old HMs, HTs, and NCs and 25.0%, 79.0%, and 38.0% of the 71\u2010 to 86\u2010year\u2010old HMs, HTs, and NCs had positive A\u03b2 PET scans, and the long\u2010term recall memory scores are significantly higher in the older HMs than in HT and NC groups, suggesting resistance to A\u03b2 deposition in those HMs who remained unimpaired at older ages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study provides information about A\u03b2 plaque burden, tau tangle burden, and neurodegeneration in cognitively unimpaired persons at three levels of genetic risk for AD. Unimpaired <jats:italic>APOE \u03b54<\/jats:italic> HMs can be studied before their 70s to evaluate the understanding of factors, processes, and interventions involved in the <jats:italic>predisposition<\/jats:italic> to and prevention of AD, and after their 70s, to discover factors, processes, and interventions involved in the <jats:italic>resilience or resistance<\/jats:italic> to and prevention of AD.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jalz.2019.08.195","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T10:06:58Z","timestamp":1575886018000},"page":"598-609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Brain imaging measurements of fibrillar amyloid\u2010\u03b2 burden, paired helical filament tau burden, and atrophy in cognitively unimpaired persons with two, one, and no copies of the <i>APOE \u03b54<\/i> allele"],"prefix":"10.1002","volume":"16","author":[{"given":"Valentina","family":"Ghisays","sequence":"first","affiliation":[{"name":"Banner Alzheimer's Institute  Phoenix AZ USA"},{"name":"Arizona Alzheimer's Consortium  Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruman D.","family":"Goradia","sequence":"additional","affiliation":[{"name":"Banner Alzheimer's Institute  Phoenix AZ USA"},{"name":"Arizona Alzheimer's Consortium  Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Protas","sequence":"additional","affiliation":[{"name":"Banner Alzheimer's Institute  Phoenix AZ USA"},{"name":"Arizona Alzheimer's Consortium  Phoenix AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Robert J.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Banner Alzheimer's Institute  Phoenix AZ USA"},{"name":"Arizona Alzheimer's Consortium  Phoenix AZ 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