Previously, a higher VRF burden had been found to be significantly interacting with amyloid burden in predicting longitudinal brain atrophy and further cognitive decline.6 Likewise, other studies37 have shown that VRFs interact with subthreshold levels of amyloid Aβ, as detected by amyloid PET, to promote cognitive decline, by partially accelerating early tau accumulation, in a cohort of cognitively unimpaired individuals. This evidence concerns the gene MAPT and Brain atrophy.