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Combining p-tau217 and digital cognitive testing to predict cognitive decline.

Hairin Kim1, Daniel Soberanes1, Roos J Jutten2

  • 1Department of Neurology, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|March 30, 2026
PubMed
Summary
This summary is machine-generated.

Digital cognitive tests measuring multi-day learning curve (MDLC) combined with plasma phosphorylated tau (p-tau217) improve prediction of cognitive decline in older adults. This combined approach offers precise risk stratification for early intervention.

Keywords:
cognitive declinedigital cognitive assessmentplasma p‐tau217preclinical Alzheimer's diseaseremote assessment

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Biomarkers

Background:

  • Cognitive decline in aging is a growing concern.
  • Plasma phosphorylated tau at threonine 217 (p-tau217) is a promising biomarker for neurodegeneration.
  • Remote digital cognitive assessments can capture learning patterns over time.

Purpose of the Study:

  • To determine if multi-day learning curve (MDLC) from digital cognitive tests adds prognostic value to p-tau217 for predicting cognitive decline.
  • To assess the combined predictive power of MDLC and p-tau217 in cognitively unimpaired older adults.

Main Methods:

  • 183 cognitively unimpaired older adults completed digital cognitive tests and provided plasma p-tau217.
  • Linear mixed-effects models analyzed the effects of baseline p-tau217 and MDLC on cognitive decline over 2.5 years.

Main Results:

  • MDLC significantly improved the prediction of cognitive decline beyond p-tau217 alone.
  • Higher p-tau217 and lower MDLC were independently associated with faster decline.
  • Individuals with elevated p-tau217 but preserved MDLC showed stable cognition.

Conclusions:

  • Combining MDLC and p-tau217 enables precise risk stratification for cognitive decline.
  • This integrated approach identifies individuals at high risk for imminent decline.
  • It may enhance screening for early preventive interventions in aging populations.