Remote cognitive tests predict neurodegenerative biomarkers in the Insight 46 cohort

BACKGROUND Alzheimer’s disease-related biomarkers detect pathology years before symptoms emerge, when disease-modifying therapies might be most beneficial. Remote cognitive testing provides a means of assessing early changes. We explored the relationship between neurodegenerative biomarkers and cognition in cognitively normal individuals. METHODS We remotely deployed 13 computerised Cognitron tasks in 255 Insight 46 participants. We generated whole brain, hippocampal, and white matter hyperintensity volumes at ages 69-71, rates of change over two-years, amyloid load and positivity. We examined the relationship between Cognitron, biomarkers, and standard neuropsychological tests. RESULTS Slower response time on a delayed recognition task predicted amyloid positivity (OR=1.79,CI:1.15, 2.95). Brain and hippocampal atrophy rates correlated with poorer visuospatial performance ( b =-0.42, CI:-0.80, -0.05) and accuracy on immediate recognition ( b =-0.01, CI:-0.01, -0.001), respectively. Standard tests correlated with Cognitron composites (rho=0.43, p<0.001). DISCUSSION Remote computerised testing correlates with standard supervised assessments and holds potential for studying early cognitive changes associated with neurodegeneration.