학술논문
Scalable plasma and digital cognitive markers for diagnosis and prognosis of Alzheimer's disease and related dementias
Document Type
article
Author
Tsoy, Elena; La Joie, Renaud; VandeVrede, Lawren; Rojas, Julio C; Yballa, Claire; Chan, Brandon; Lago, Argentina Lario; Rodriguez, Anne‐Marie; Goode, Collette A; Erlhoff, Sabrina J; Tee, Boon Lead; Windon, Charles; Lanata, Serggio; Kramer, Joel H; Miller, Bruce L; Dilworth‐Anderson, Peggye; Boxer, Adam L; Rabinovici, Gil D; Possin, Katherine L
Source
Alzheimer's & Dementia. 20(3)
Subject
Language
Abstract
IntroductionWith emergence of disease-modifying therapies, efficient diagnostic pathways are critically needed to identify treatment candidates, evaluate disease severity, and support prognosis. A combination of plasma biomarkers and brief digital cognitive assessments could provide a scalable alternative to current diagnostic work-up.MethodsWe examined the accuracy of plasma biomarkers and a 10-minute supervised tablet-based cognitive assessment (Tablet-based Cognitive Assessment Tool Brain Health Assessment [TabCAT-BHA]) in predicting amyloid β positive (Aβ+) status on positron emission tomography (PET), concurrent disease severity, and functional decline in 309 older adults with subjective cognitive impairment (n = 49), mild cognitive impairment (n = 159), and dementia (n = 101).ResultsCombination of plasma pTau181, Aβ42/40, neurofilament light (NfL), and TabCAT-BHA was optimal for predicting Aβ-PET positivity (AUC = 0.962). Whereas NfL and TabCAT-BHA optimally predicted concurrent disease severity, combining these with pTau181 and glial fibrillary acidic protein was most accurate in predicting functional decline.DiscussionCombinations of plasma and digital cognitive markers show promise for scalable diagnosis and prognosis of ADRD.HighlightsThe need for cost-efficient diagnostic and prognostic markers of AD is urgent. Plasma and digital cognitive markers provide complementary diagnostic contributions. Combination of these markers holds promise for scalable diagnosis and prognosis. Future validation in community cohorts is needed to inform clinical implementation.