Technology and Dementia Preconference.

Area of Science:

• Neuroscience
• Clinical Trials
• Digital Health

Background:

• Alzheimer's disease (AD) clinical trials require sensitive progression detection, which is challenging due to confounding factors like aging and insensitive traditional assessments (e.g., ADAS-Cog).
• Home-based, multimodal digital assessments offer a potential solution to improve the sensitivity and efficiency of dementia clinical trials.

Purpose of the Study:

• To evaluate the feasibility and value of repeated, multimodal digital assessments using the NeuLogiq platform in Alzheimer's dementia patients at home over 12 months.
• To quantify the statistical power of digital measures compared to conventional endpoints for detecting disease progression.

Main Methods:

• A non-interventional study involving 59 mild dementia patients and 60 controls across seven UK sites.
• Participants performed 8 cognitive tasks on a tablet with synchronous low-burden EEG at home, with 26 samples per task over 52 weeks.
• Benchmark assessments (ADAS-Cog) and blood plasma were collected periodically; progression analyzed using mixed-effects models.

Main Results:

• While traditional measures like ADAS-Cog showed modest progression differences, two NeuLogiq digital measures demonstrated significantly higher sensitivity: a tablet-based associative memory task and a psychomotor task.
• These digital tasks showed larger effect sizes than ADAS-Cog and survived correction for multiple comparisons.
• Post-hoc analysis indicated that digital tasks could differentiate patients based on p-tau status and executive function.

Conclusions:

• Individual tablet-based cognitive tasks performed autonomously at home are more sensitive measures of Alzheimer's disease progression than the ADAS-Cog.
• Digital assessments hold promise for increasing the statistical power, reducing the size, duration, and risk of dementia clinical trials.