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Scalable plasma and digital cognitive markers for diagnosis and prognosis of Alzheimer's disease and related dementias.
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.
Affiliation
  • Tsoy E; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • La Joie R; Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.
  • VandeVrede L; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Rojas JC; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Yballa C; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Chan B; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Lago AL; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Rodriguez AM; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Goode CA; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Erlhoff SJ; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Tee BL; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Windon C; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Lanata S; Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.
  • Kramer JH; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Miller BL; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Dilworth-Anderson P; Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.
  • Boxer AL; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
  • Rabinovici GD; Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA.
  • Possin KL; Department of Neurology, University of California San Francisco, San Francisco, California, USA.
Alzheimers Dement ; 20(3): 2089-2101, 2024 03.
Article in En | MEDLINE | ID: mdl-38224278
ABSTRACT

INTRODUCTION:

With 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.

METHODS:

We 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 ß positive (Aß+) 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).

RESULTS:

Combination of plasma pTau181, Aß42/40, neurofilament light (NfL), and TabCAT-BHA was optimal for predicting Aß-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.

DISCUSSION:

Combinations of plasma and digital cognitive markers show promise for scalable diagnosis and prognosis of ADRD. HIGHLIGHTS The 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.
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Full text: 1 Database: MEDLINE Main subject: Alzheimer Disease / Cognitive Dysfunction Type of study: Diagnostic_studies / Prognostic_studies Limits: Aged / Humans Language: En Year: 2024 Type: Article
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Full text: 1 Database: MEDLINE Main subject: Alzheimer Disease / Cognitive Dysfunction Type of study: Diagnostic_studies / Prognostic_studies Limits: Aged / Humans Language: En Year: 2024 Type: Article