Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
Combining p-tau217 and digital cognitive testing to predict cognitive decline.
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Kim Hairin, Soberanes Daniel, Jutten Roos J, Dubbelman Mark A, Yang Hyun-Sik, Marshall Gad A, Johnson Keith A, Betensky Rebecca A, Kivisäkk Pia, Arnold Steven E, Gorham Anna, Serrano-Pozo Alberto, Simpson Beata-Gabriela K, Rentz Dorene M, Sperling Reisa A, Amariglio Rebecca E, Papp Kathryn V
Аннотация
INTRODUCTION: We investigated whether a multi-day learning curve (MDLC), derived from remote digital cognitive assessments over 1 week, adds prognostic value to plasma phosphorylated tau at threonine 217 (p-tau217) for predicting cognitive decline in cognitively unimpaired (CU) older adults.
METHODS: A total of 183 CU participants (mean age 73.3; 70% female) completed multi-day digital cognitive tests and provided plasma p-tau217. Linear mixed-effects models evaluated the independent and combined effects of baseline p-tau217 and MDLC on longitudinal cognitive decline over 2.5 years.
RESULTS: Adding MDLC to p-tau217 significantly explained longitudinal cognitive trajectory beyond p-tau217 alone. Although higher p-tau217 and lower MDLC were independently associated with steeper decline, individuals with both risk factors declined the fastest. Notably, those with elevated p-tau217 level but preserved MDLC remained stable, distinguishing them from those at imminent risk.
DISCUSSION: Combining digital learning metrics with plasma p-tau217 enables precise risk stratification. This approach identifies individuals most vulnerable to imminent decline, potentially enhancing screening for early preventive interventions.
METHODS: A total of 183 CU participants (mean age 73.3; 70% female) completed multi-day digital cognitive tests and provided plasma p-tau217. Linear mixed-effects models evaluated the independent and combined effects of baseline p-tau217 and MDLC on longitudinal cognitive decline over 2.5 years.
RESULTS: Adding MDLC to p-tau217 significantly explained longitudinal cognitive trajectory beyond p-tau217 alone. Although higher p-tau217 and lower MDLC were independently associated with steeper decline, individuals with both risk factors declined the fastest. Notably, those with elevated p-tau217 level but preserved MDLC remained stable, distinguishing them from those at imminent risk.
DISCUSSION: Combining digital learning metrics with plasma p-tau217 enables precise risk stratification. This approach identifies individuals most vulnerable to imminent decline, potentially enhancing screening for early preventive interventions.