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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Clinical Manifestations.

Daniel Soberanes1, Roos J Jutten2, Mark A Dubbelman3

  • 1Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Combining digital memory tests and blood biomarkers like p-tau217 can predict cognitive decline in older adults. This approach improves accuracy in identifying individuals at risk for Alzheimer's disease progression.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Biomarker Research

Background:

  • Early identification of individuals at risk for Alzheimer's disease (AD) cognitive decline is crucial for timely intervention.
  • Remote digital cognitive testing and blood-based biomarkers offer a cost-effective strategy for risk assessment.

Purpose of the Study:

  • To evaluate if a multi-day learning curve (MDLC) from digital cognitive testing, combined with plasma p-tau217 levels, can predict cognitive decline over two years in unimpaired older adults.
  • To assess the predictive power of MDLCs and p-tau217, individually and combined, for identifying individuals who will experience cognitive decline.

Main Methods:

  • Two hundred cognitively unimpaired older adults underwent daily remote cognitive testing for seven days to derive MDLCs.
  • Baseline assessments included the Preclinical Alzheimer's Cognitive Composite (PACC-5) and plasma p-tau217.
  • Linear mixed-effects models and receiver operating characteristic (ROC) analyses were used to assess prediction of PACC-5 decline over an average of 2.3 years.

Main Results:

  • Higher baseline p-tau217 and lower baseline MDLCs were significantly associated with longitudinal cognitive decline.
  • p-tau217 alone predicted cognitive decliners with an AUC of 0.63.
  • Adding MDLCs to p-tau217 significantly improved predictive accuracy to an AUC of 0.82.

Conclusions:

  • A remote digital assessment of memory consolidation (MDLC) explains unique variance in cognitive decline when combined with p-tau217 in unimpaired older adults.
  • The combination of MDLCs and p-tau217 enhances the accuracy of identifying individuals at high risk for imminent cognitive decline.
  • Pairing sensitive digital cognitive assessments with plasma biomarkers is effective for early risk identification in preclinical Alzheimer's disease.