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Hi, Roos! Thank you!

To answer your question, Alzheimer's disease is typified by atrophy in brain areas such as the hippocampus (but in later stages also other areas) and by plaques. The current neuroimaging techniques are unable to show the specific atrophy and plaque build-up needed to officially diagnose Alzheimer's disease. In practice, however, the diagnosis is based on behavioural outcomes and projections of future behaviour  (e.g. more specific cognitive decline) due to the impossibility to look into the brain! Hope this answers your questions!