Developments in scalable strategies for detecting early markers of cognitive decline

Abstract

Effective strategies for early detection of cognitive decline, if deployed on a large scale, would have individual and societal benefits. However, current detection methods are invasive or time-consuming and therefore not suitable for longitudinal monitoring of asymptomatic individuals. For example, biological markers of neuropathology associated with cognitive decline are typically collected via cerebral spinal fluid, cognitive functioning is evaluated from face-to-face assessments by experts and brain measures are obtained using expensive, non-portable equipment. Here, we describe scalable, repeatable, relatively non-invasive and comparatively inexpensive strategies for detecting the earliest markers of cognitive decline. These approaches are characterized by simple data collection protocols conducted in locations outside the laboratory: measurements are collected passively, by the participants themselves or by non-experts. The analysis of these data is, in contrast, often performed in a centralized location using sophisticated techniques. Recent developments allow neuropathology associated with potential cognitive decline to be accurately detected from peripheral blood samples. Advances in smartphone technology facilitate unobtrusive passive measurements of speech, fine motor movement and gait, that can be used to predict cognitive decline. Specific cognitive processes can be assayed using ‘gamified’ versions of standard laboratory cognitive tasks, which keep users engaged across multiple test sessions. High quality brain data can be regularly obtained, collected at-home by users themselves, using portable electroencephalography. Although these methods have great potential for addressing an important health challenge, there are barriers to be overcome. Technical obstacles include the need for standardization and interoperability across hardware and software. Societal challenges involve ensuring equity in access to new technologies, the cost of implementation and of any follow-up care, plus ethical issues.

Accelerating P300-based neurofeedback training for attention enhancement using iterative learning control: a randomised controlled trial

“…For instance, the alpha band (7)(8)(9)(10)(11)(12)(13), primarily observed in posterior brain regions, is associated with relaxed wakefulness, and a decrease in alpha activity is linked to improved concentration and sustained attention [12]. The sensorimotor rhythm (SMR), a sub-band of the beta band (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) and found as oscillations between 12 and 15 Hz over the sensorimotor cortex, is also associated with attention, with its upregulation frequently targeted [13]. Additionally, the theta band (5-7 Hz) is frequently used in NFB training due to its association with memory [14].…”

“…Similarly, the N200 ERP, also triggered by the oddball paradigm, is associated with attention [19]. ERPs have also been investigated as potential biomarkers for conditions, such as ADHD [21], mild cognitive impairment and dementia [22].…”

Circulating microRNAs are related to cognitive domains in the general population

“…Moreover, their sensitivity in the very early stages of cognitive dysfunction, and in highly educated persons, is limited [3]. The identification of blood-based molecular biomarkers of subclinical cognitive dysfunction could facilitate earlier and more reliable detection of individuals at risk of accelerated cognitive aging or neurodegeneration [4]. Additionally, such biomarkers might point to specific pathophysiologic processes involved in cognitive aging, and thus help the development of targeted interventions.…”

Enhancing Early Detection of Cognitive Decline in the Elderly: A Comparative Study Utilizing Large Language Models in Clinical Notes

“…11 The variability in screening practices further complicates early detection during standard medical evaluations. 12 13 Additionally, constraints such as limited access to specialized care providers, including neurologists and geriatricians, exacerbate delays in diagnosis and treatment initiation.…”