TY - JOUR
T1 - Speech-based digital cognitive assessment for clinical trials
T2 - detecting cognitive impairment stages and AD biomarker relations across European cohorts
AU - König, Alexandra
AU - Tröger, Johannes
AU - Mallick, Elisa
AU - Linz, Nicklas
AU - Ritchie, Craig
AU - Gregory, Sarah
AU - Hunter, Matthew
AU - Johnson, Kay
AU - Benavides, Gonzalo Sánchez
AU - Grau-Rivera, Oriol
AU - Radoi, Andreea
AU - Porta-Mas, Claudia
AU - Köhler, Stefanie
AU - Teipel, Stefan
AU - Hansson, Oskar
AU - Tideman, Pontus
AU - Wuestefeld, Anika
AU - Palmqvist, Sebastian
N1 - Funding: This study is funded by the Alzheimer's Drug Discovery Foundation Diagnostic Accelerator program. The β-AARC study was supported by Alzheimer's Drug Discovery Foundation (ADDF) grants #RDADB-201906-2018897 and #201809-2016862. Additionally, the study has been funded by the Health Department of the Catalan Government. G.S.B. is supported by Instituto de Salud Carlos III (ISCIII) through the project CP23/00039 (Miguel Servet contract), co-funded by the European Union (FSE+). The BioFINDER-Primary Care study was supported by the National Institute on Aging (R01AG083740), European Research Council (ADG-101096455), Alzheimer's Association (ZEN24-1069572, SG-23-1061717), GHR Foundation, the Kamprad Foundation (#20243058), Swedish Research Council (2018-02052, 2022-00775), ERA PerMed (ERAPERMED2021-184), Knut and Alice Wallenberg foundation (2022-0231), Strategic Research Area MultiPark (Multidisciplinary Research in Parkinson's disease) at Lund University, Bundy Academy, AD Riddle (an Innovative Health Initiative), Swedish Alzheimer Foundation (AF-980907, AF-1011949, AF-994075, AF-940046, AF-981132), Swedish Brain Foundation (FO2021-0293, FO2022-0204, FO2024-0284), Parkinson foundation of Sweden (1412/22), Cure Alzheimer's fund, Rönström Family Foundation (FRS-0004, FRS-0011), Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Skåne University Hospital Foundation (2020-O000028), Regionalt Forskningsstöd (2022-1259), and the Swedish federal government under the ALF agreement (2022-Projekt0080, 2022-1346).
PY - 2026/5
Y1 - 2026/5
N2 - INTRODUCTION: Early detection of Alzheimer's disease (AD) is critical for timely intervention as disease-modifying treatments emerge. Speech-based digital biomarkers offer scalable options for remotely capturing speech-derived functional changes associated with early cognitive decline, but validation across real-world populations remains limited.METHODS: We evaluated the speech biomarker for cognition (SB-C), an automated speech-derived measure associated with cognitive status, in 736 participants across five European cohorts (Barcelonaβeta Brain Research Center's Alzheimer's at-risk cohort, European Prevention of Alzheimer's Dementia Scotland, Dementia Study of Cognitive and Biomarker Dynamics, Longitudinal Cognitive Impairment and Dementia Study, and Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably [BioFINDER-Primary Care]). Participants completed verbal learning and semantic fluency tasks via automated phone or app-based platforms. SB-C performance was compared to Mini-Mental State Examination, Clinical Dementia Rating, Preclinical Alzheimer Cognitive Composite 5, and cerebrospinal fluid amyloid beta and phosphorylated tau181 biomarker status.RESULTS: SB-C significantly differentiated cognitively unimpaired and impaired groups (P < 0.001), correlated with standard cognitive measures, and showed moderate-to-high area under the curve (0.56-0.82) for classifying biomarker positivity, with strongest results in BioFINDER-Primary Care.DISCUSSION: SB-C is a scalable, remote speech-derived marker associated with cognitive status and AD biomarker group differences.
AB - INTRODUCTION: Early detection of Alzheimer's disease (AD) is critical for timely intervention as disease-modifying treatments emerge. Speech-based digital biomarkers offer scalable options for remotely capturing speech-derived functional changes associated with early cognitive decline, but validation across real-world populations remains limited.METHODS: We evaluated the speech biomarker for cognition (SB-C), an automated speech-derived measure associated with cognitive status, in 736 participants across five European cohorts (Barcelonaβeta Brain Research Center's Alzheimer's at-risk cohort, European Prevention of Alzheimer's Dementia Scotland, Dementia Study of Cognitive and Biomarker Dynamics, Longitudinal Cognitive Impairment and Dementia Study, and Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably [BioFINDER-Primary Care]). Participants completed verbal learning and semantic fluency tasks via automated phone or app-based platforms. SB-C performance was compared to Mini-Mental State Examination, Clinical Dementia Rating, Preclinical Alzheimer Cognitive Composite 5, and cerebrospinal fluid amyloid beta and phosphorylated tau181 biomarker status.RESULTS: SB-C significantly differentiated cognitively unimpaired and impaired groups (P < 0.001), correlated with standard cognitive measures, and showed moderate-to-high area under the curve (0.56-0.82) for classifying biomarker positivity, with strongest results in BioFINDER-Primary Care.DISCUSSION: SB-C is a scalable, remote speech-derived marker associated with cognitive status and AD biomarker group differences.
KW - Humans
KW - Male
KW - Female
KW - Biomarkers/cerebrospinal fluid
KW - Cognitive dysfunction/diagnosis
KW - Alzheimer Disease/diagnosis
KW - Aged
KW - Amyloid beta-Peptides/cerebrospinal fluid
KW - Europe
KW - Cohort studies
KW - Speech
KW - Neuropsychological tests
KW - Tau proteins/cerebrospinal fluid
KW - Aged, 80 and over
KW - Middle aged
U2 - 10.1002/alz.71462
DO - 10.1002/alz.71462
M3 - Article
C2 - 42151661
SN - 1552-5260
VL - 22
SP - 1
EP - 14
JO - Alzheimer's and Dementia
JF - Alzheimer's and Dementia
IS - 5
M1 - e71462
ER -