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

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.