In 2011, the Alzheimer's Association Research Roundtable convened a workgroup to publish recommendations for detecting and monitoring amyloid-related imaging abnormalities (ARIA) in Alzheimer's clinical trials. Since then, anti-amyloid therapies have received regulatory approval and entered clinical practice, increasing the need to better inform health care providers, researchers and patients about ARIA's implications in real-world settings.

In response, the Alzheimer's Association convened a new workgroup to update ARIA recommendations in this evolving treatment landscape. The recommendations, published in the April 2026 issue of Alzheimer's & Dementia®: The Journal of the Alzheimer's Association, provide updated insights and recommendations on ARIA terminology, radiologic detection, risk factors, mitigation strategies, clinical decision making and future research priorities. This work builds on and extends the 2011 Alzheimer's Association Research Roundtable recommendations on ARIA in amyloid-modifying therapeutic trials, shifting the focus from clinical trials to safe and effective implementation in clinical practice.

The 2011 Alzheimer's Association Research Roundtable ARIA Workgroup

In its 2011 recommendations published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the workgroup — whose members were listed as co-authors with their conflicts of interest (COIs) disclosed in the paper — outlined a framework for detecting and managing ARIA in clinical trials. Key elements of these recommendations included:

• MRI protocol minimum standards for detection of ARIA.
• Frequency and intensity of scanning protocols.
• Reading and reporting standards for interpreting MRI results.
• Thresholds for excluding participants in anti-amyloid clinical trials based on ARIA.
• Recommendations for further research into the mechanisms underlying ARIA.

The 2024 Alzheimer's Association ARIA Workgroup

The Alzheimer's Association convened the 2024 ARIA Workgroup, bringing together leading experts in neurology, neuroradiology, basic science and bioethics to update ARIA recommendations and define priorities for future research.

The resulting publication highlights that effective ARIA detection and monitoring in clinical practice requires robust protocols, careful coordination across care teams and continued collection of real-world data to improve patient safety. The recommendations address key areas, including:

• Considerations for ARIA terminology.

• Mitigation of serious adverse events related to ARIA.

• Treatment indications and Cerebral Amyloid Angiopathy (CAA) considerations.

• Antithrombotic and stroke treatment considerations in the context of anti-amyloid therapies.

These recommendations are intended to inform the field broadly but do not represent a clinical practice guideline or prescriptive care pathway.

Key areas for future research span:

• Advancing mechanistic understanding of ARIA.

• Improving early and more accurate detection methods, especially for mild or evolving ARIA.

• Understanding the role of novel biomarkers in ARIA risk stratification, detection, monitoring and management.

• Optimizing management strategies with a focus on preventing serious and symptomatic ARIA.

• Understanding long-term clinical outcomes of ARIA.

• Expanding generalizability.

• Strengthening interdisciplinary collaboration to expand real-world data collection and evidence generation.

Contact us

Questions and concerns about the Alzheimer's Association ARIA Workgroup can be directed to Simin Mahinrad, M.D., Ph.D., director, Medical Writing, at simahinrad@alz.org.