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

Background beta-amyloid (A beta) and tau positron emission tomography (PET) detect the pathological changes that define Alzheimer's disease (AD) in living people. Cognitive measures sensitive to A beta 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 A beta -PET status using logistic regression models in individuals with mild cognitive impairment (MCI) or dementia (N = 140; 43 A beta-, 97 A beta+). 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 A beta+ individuals with MCI or dementia. Results Favorites (associative memory), Match (executive functions and speed), and Everyday Cognition Scale scores were significantly associated with A beta 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 A beta and regional tau in vivo imaging markers and could be used for the identification of patients with suspected AD pathology in clinical practice.

Automated summary

Beta-amyloid (A beta) and tau positron emission tomography (PET) can detect the pathological changes of Alzheimer's disease (AD). Cognitive measures based on the Brain Health Assessment (BHA) tablet are significantly associated with A beta positivity and regional tau-PET signal. The BHA measures could potentially be used for identifying patients with suspected AD pathology in clinical practice.