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BMC Neurology
Published in: BMC Neurology 1/2022

Open Access 01-12-2022 | Artificial Intelligence | Study protocol

The TAS Test project: a prospective longitudinal validation of new online motor-cognitive tests to detect preclinical Alzheimer’s disease and estimate 5-year risks of cognitive decline and dementia

Authors: Jane Alty, Quan Bai, Renjie Li, Katherine Lawler, Rebecca J. St George, Edward Hill, Aidan Bindoff, Saurabh Garg, Xinyi Wang, Guan Huang, Kaining Zhang, Kaylee D. Rudd, Larissa Bartlett, Lynette R. Goldberg, Jessica M. Collins, Mark R. Hinder, Sharon L. Naismith, David C. Hogg, Anna E. King, James C. Vickers

Published in: BMC Neurology | Issue 1/2022

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Abstract

Background

The worldwide prevalence of dementia is rapidly rising. Alzheimer’s disease (AD), accounts for 70% of cases and has a 10–20-year preclinical period, when brain pathology covertly progresses before cognitive symptoms appear. The 2020 Lancet Commission estimates that 40% of dementia cases could be prevented by modifying lifestyle/medical risk factors. To optimise dementia prevention effectiveness, there is urgent need to identify individuals with preclinical AD for targeted risk reduction. Current preclinical AD tests are too invasive, specialist or costly for population-level assessments. We have developed a new online test, TAS Test, that assesses a range of motor-cognitive functions and has capacity to be delivered at significant scale. TAS Test combines two innovations: using hand movement analysis to detect preclinical AD, and computer-human interface technologies to enable robust ‘self-testing’ data collection. The aims are to validate TAS Test to [1] identify preclinical AD, and [2] predict risk of cognitive decline and AD dementia.

Methods

Aim 1 will be addressed through a cross-sectional study of 500 cognitively healthy older adults, who will complete TAS Test items comprising measures of motor control, processing speed, attention, visuospatial ability, memory and language. TAS Test measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 (p-tau181). Aim 2 will be addressed through a 5-year prospective cohort study of 10,000 older adults. Participants will complete TAS Test annually and subtests of the Cambridge Neuropsychological Test Battery (CANTAB) biennially. 300 participants will undergo in-person clinical assessments. We will use machine learning of motor-cognitive performance on TAS Test to develop an algorithm that classifies preclinical AD risk (p-tau181-defined) and determine the precision to prospectively estimate 5-year risks of cognitive decline and AD.

Discussion

This study will establish the precision of TAS Test to identify preclinical AD and estimate risk of cognitive decline and AD. If accurate, TAS Test will provide a low-cost, accessible enrichment strategy to pre-screen individuals for their likelihood of AD pathology prior to more expensive tests such as blood or imaging biomarkers. This would have wide applications in public health initiatives and clinical trials.

Trial registration

ClinicalTrials.gov Identifier: NCT05194787, 18 January 2022. Retrospectively registered.
Appendix
Available only for authorised users
Footnotes
1
Tasmania is an island state in South East Australia
 
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Metadata
Title
The TAS Test project: a prospective longitudinal validation of new online motor-cognitive tests to detect preclinical Alzheimer’s disease and estimate 5-year risks of cognitive decline and dementia
Authors
Jane Alty
Quan Bai
Renjie Li
Katherine Lawler
Rebecca J. St George
Edward Hill
Aidan Bindoff
Saurabh Garg
Xinyi Wang
Guan Huang
Kaining Zhang
Kaylee D. Rudd
Larissa Bartlett
Lynette R. Goldberg
Jessica M. Collins
Mark R. Hinder
Sharon L. Naismith
David C. Hogg
Anna E. King
James C. Vickers
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-022-02772-5

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