AbstractBackgroundIdentifying early signs of neurodegeneration due to Alzheimer’s disease (AD) is a necessary first step towards preventing cognitive decline. Individual cortical thickness measures, available after processing anatomical magnetic resonance imaging (MRI), are sensitive markers of neurodegeneration. However, cortical decline in aging and high inter‐individual variability complicates the determination of AD‐related neurodegeneration on trajectories. Further, the high‐dimensional nature of these trajectories necessitate the use of a transformation into lower‐dimensional spaces in order to perform comparative statistical analyses, model decline, and identify criteria differentiating pathological from normal trajectories.MethodIn this project, we computed trajectories in a 2D representation of a 62‐dimensional manifold of individual cortical thickness measures. To compute this representation, we used a nonlinear dimension reduction algorithm called Uniform Manifold Approximation and Projection (UMAP). We first created a UMAP embedding on measurements from 6,237 cognitively healthy participants (3,556 women) aged 18 to 100 years old from the NOMIS database. We then projected longitudinal data from 537 mild cognitively impaired (MCI) subjects and 340 AD subjects from ADNI into this embedding. Each participant had multiple visits (n = 2), one year apart. Finally, differences in trajectories were analysed by clustering the reduced data and comparing the positional variations through time between MCI and AD subjects. The validity of the approach was verified through cross‐validation.ResultFirst, the embedding was shown to be positively associated (r = 0.65) with participants' age (see figure 1) in the NOMIS data. When projected in this space, differences between ADNI’s MCI and AD distributions were found (see figure 2). Average trajectories between clusters were shown to be significantly different between MCI and AD subjects (see figure 3). Moreover, we showed that some clusters and trajectories between clusters were more prone to host AD subjects. Finally, cross‐validation showed an accuracy of up to 72% at predicting cognitive decline in MCI participants over 2,000 bootstrap iterations.ConclusionA 2D low‐dimensional cortical thickness representation embeds sufficient discriminatory information as to predict decline to AD in MCI participants with strong accuracy.