Scientists say they have found a possible hidden Alzheimer’s tipping point that could help explain why some people with Alzheimer’s-related brain changes go on to develop dementia while others do not. The work points to a major biological shift in the brain, rather than simply the presence of plaques and tau alone, as a key factor in whether symptoms worsen.

According to the research, the deciding factor may be how the brain’s immune cells react as these hallmark Alzheimer’s changes build up. That response appears to influence whether the disease process remains more contained or moves toward the kind of damage linked with dementia.

The study involved researchers from VIB, KU Leuven, the UK Dementia Research Institute and Muna Therapeutics, with funding that included support from the European Research Council. Their findings suggest that the immune system inside the brain may play a larger role in Alzheimer’s progression than previously understood.

The discovery could matter for future treatment strategies because it highlights a new potential target for drug development. If scientists can better understand or influence this biological tipping point, it may open the way to therapies designed to slow or prevent the transition from Alzheimer’s-related brain changes to dementia.