Biomarkers play an important role in early detection and intervention in Alzheimer’s disease (AD). However, obtaining effective biomarkers for AD is still a big challenge. In this work, we propose to use the worst transportation cost as a univariate biomarker to index cortical morphometry for tracking AD progression. The worst transportation (WT) aims to find the least economical way to transport one measure to the other, which contrasts to the optimal transportation (OT) that finds the most economical way between measures. To compute the WT cost, we generalize the Brenier theorem for the OT map to the WT map, and show that the WT map is the gradient of a concave function satisfying the Monge-Ampere equation. We also develop an efficient algorithm to compute the WT map based on computational geometry. We apply the algorithm to analyze cortical shape difference between dementia due to AD and normal aging individuals. The experimental results reveal the effectiveness of our proposed method which yields better statistical performance than other competiting methods including the OT.