Concept for the combination of blood and digital markers: ideas from the PROSPECT‐AD study

Abstract

AbstractWhile knowledge about dementia and its causes is progressing rapidly, it remains challenging in clinical practice to detect accurately cognitive decline in the early stages of neurodegenerative diseases such as Alzheimer’s disease (AD). Improving the identification of early changes in the population is a prerequisite for dementia prevention and offering future disease‐modifying treatments to individuals most likely to benefit. PET and CSF biomarkers are the most widely used biomarkers to aid diagnosis in clinical research but present major limitations for clinical practice (i.e., cost, accessibility).Thus, the importance to find cost‐effective, and easily accessible tools for early detection has resulted in the development of innovative solutions that are specifically geared towards facilitating the population wide screening of at‐risk individuals.Emerging blood‐based markers have the potential for widespread clinical use, and could facilitate timely diagnosis. However, several limitations must be overcome such as finding standardized techniques for measurements of blood biomarkers, establishing reliable cutoff values for individual biomarkers, or addressing the impact of confounding factors.Recently speech analysis has become mature enough to automate speech‐based testing procedures and capture clinically fine‐grained features that are highly sensitive to early cognitive changes. Hence, speech can be utilized to indicate potential candidates to advance in the screening funnel for an on‐site more comprehensive assessment stage.Supplementing the assessment of subjective complaints by automatized speech based analysis of cognitive tests and blood‐based AD biomarkers may offer a feasible approach for effective and cost‐efficient community‐based screening programs.PROSPECT‐AD aims to scale up and to validate a novel, digital, and solely speech‐based biomarker extracted from an ordinary telephone to enable remote screening of early AD subjects. Within the PROSPECT‐AD project, novel speech features extracted during remote cognitive testing, and blood AD biomarker measurements will be compared to gold standard AD biomarker such as CSF‐amyloid‐β 1‐42 and CSF p‐Tau to assess value of a combinational approach. For this, the project collaborates with already ongoing cohorts such as EPAD (UK), DESCRIBE and DELCODE (Germany), BioFINDER Primary Care (Sweden) and Beta‐AARC (Spain) by adding the collection of speech data to existing protocols or as follow‐up assessments over the telephone.