Detecting Alzheimer’s disease biomarkers with a brief tablet-based cognitive battery: sensitivity to Aβ and tau PET

Abstract

Background β-amyloid (Aβ) and tau positron emission tomography (PET) detect the pathological changes that define Alzheimer’s disease (AD) in living people. Cognitive measures sensitive to Aβ and tau burden may help streamline identification of cases for confirmatory AD biomarker testing. Methods We examined the association of Brain Health Assessment (BHA) tablet-based cognitive measures with dichotomized Aβ -PET status using logistic regression models in individuals with mild cognitive impairment (MCI) or dementia (N = 140; 43 Aβ-, 97 Aβ+). We also investigated the relationship between the BHA tests and regional patterns of tau-PET signal using voxel-wise regression analyses in a subsample of 60 Aβ+ individuals with MCI or dementia. Results Favorites (associative memory), Match (executive functions and speed), and Everyday Cognition Scale scores were significantly associated with Aβ positivity (area under the curve [AUC] = 0.75 [95% CI 0.66–0.85]). We found significant associations with tau-PET signal in mesial temporal regions for Favorites, frontoparietal regions for Match, and occipitoparietal regions for Line Orientation (visuospatial skills) in a subsample of individuals with MCI and dementia. Conclusion The BHA measures are significantly associated with both Aβ and regional tau in vivo imaging markers and could be used for the identification of patients with suspected AD pathology in clinical practice.

The German version of the tablet‐based UCSF Brain Health Assessment is sensitive to early symptoms of neurodegenerative disorders

“…To improve early diagnosis of patients with progressive neurodegenerative disorders, efficient and accurate cognitive screens are needed for PCP across the world (Borson et al, 2013). Two previous studies The tablet-based BHA/BHS was previously validated at the clinical, neuroanatomical, and neuropathological level (Possin et al, 2018;Tsoy et al, 2021). The face-to-face test includes automated scoring and is easily used even by individuals with cognitive impairment and limited computer experience.…”

“…This validation study conducted in a sample of highly educated, White, and English-speaking patients in the United States showed that the tablet-based cognitive assessment (BHA) alone, as well as in conjunction with the informant survey, shows excellent combined sensitivity and specificity to typical and atypical presentations of mild neurocognitive disorder and dementia, outperforming the widely used MoCA (Possin et al, 2018). In addition, a longitudinal follow-up study demonstrated that the instrument is also sensitive to changes over time, even to very subtle changes in healthy individuals with positive amyloid status (Tsoy et al, 2021).…”

Remote and in‐clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults

“…26 The BHA has also demonstrated sensitivity to predict cerebral beta-amyloid (Aβ) status in cognitively normal individuals and associations with regional levels of tau positron emission tomography (PET) signal in the medial temporal lobe. 27,28 Harvard Aging Brain Study (HABS) researchers have also developed and/or validated several digital assessments with cognitively healthy adults, including tablet and digital pen-based measures. The HABS demonstrated that performance on a digitized clock drawing measure, the DCTclock TM , is able to distinguish between normal cognition and MCI and is associated with cerebral amyloid and tau pathology, suggesting utility for early detection.…”

“…BHA subtests have shown moderate to high correlations with reference standard neuropsychological tests, as well as medial temporal, frontal, parietal, and basal ganglia volumes 26 . The BHA has also demonstrated sensitivity to predict cerebral beta‐amyloid (Aβ) status in cognitively normal individuals and associations with regional levels of tau positron emission tomography (PET) signal in the medial temporal lobe 27,28 . Harvard Aging Brain Study (HABS) researchers have also developed and/or validated several digital assessments with cognitively healthy adults, including tablet and digital pen‐based measures.…”

Memory for Semantically Related Objects Differentiates Cognitively Unimpaired Autosomal Dominant Mutation Carriers from Non-Carrier Family Members

“…Within this context, the development of unique and innovative technological approaches to detecting and tracking cognitive changes occurring early in conditions like AD is necessary. One such approach is the development of remotely administered computerized cognitive assessments ( 2 ). There have been several computerized cognitive tests that have been created and validated over the last decade ( 3 – 9 ), though notably the study and validation of computerized cognitive tests in culturally diverse samples needs significant attention moving forward ( 10 ).…”