Biomarkers.

Background: Sleep disorders as a contributing factor to cognitive impairment have spurred growing interest. The advent of digital technology facilitates the collection of comprehensive sleep measures in a home setting. The objective of this study is to examine the association between digital sleep measures and the Montreal Cognitive Assessment (MoCA).

Biomarkers.

Background: Recent technological advancements have revolutionized our approach to healthcare, enabling us to harness the potential of smartphones and wearables to collect data that can be used to characterize Alzheimer's disease (AD) heterogeneity and to develop digital biomarkers. Our focus is to create comprehensive cross-domain digital datasets and establish an infrastructure that allows for seamless data sharing. Central to accelerating the potential of digital biomarkers for more accurate and early detection is privacy-protecting data access, which when combined with deep molecular phenotyping, will enhance our understanding of the biological mechanisms underlying clinical expression.

Biomarkers.

Background: Plasma-based biomarkers are emerging as a new diagnostic tool for Alzheimer's disease (AD) with high accuracy and low cost. Whether aggregated plasma protein risk score (PPRS) derived from a single sample could be useful for diagnosis of incident mild cognitive impairment (MCI) and AD is uncertain. This study aims to understand the association between PPRS and future risk of AD related outcomes.

Biomarkers.

Background: Producing speech is a cognitively complex task and can be collected through devices such as handheld recorders, tablets, and smartphones. Digital voice data can also capture information at a granular millisecond-level precision and serve as a widespread tool to collect cognitively relevant data in almost any diverse real-world environments. Digital voice recordings of spoken responses to neuropsychological test questions have been collected through the Framingham Heart Study (FHS) since 2005.

Biomarkers.

Background: The prevalence of cognitive impairments, such as mild cognitive impairment (MCI) and Alzheimer's disease (AD), has surged, necessitating rapid, cost-effective, and non-invasive diagnostic tools. Speech, as a rich source of cognitive indices, offers a promising avenue for distinguishing between healthy controls, MCI, and AD groups. However, the utilization of voice data poses privacy challenges, as speaker identities can be discerned through automatic speaker verification systems.

Biomarkers.

Background: Widely used neuropsychological test instruments are notoriously biased across the demographics of age, sex/gender, education, language and culture. This includes verbal memory tests that elicit speech such as the paragraph recall or list-learning memory tests. Language tests are similarly biased, including the Boston Diagnostic Aphasia Examination Cookie Theft Test (CTT) that has been used to elicit both written and spoken responses for decades.

Biomarkers.

Background: Preclinical measures of Alzheimer's disease (AD) risk include markers of amyloid and tau measured via PET scans and decline in verbal memory. Audio features from recorded speech collected during neuropsychological testing offer an alternative for monitoring preclinical AD symptoms that is nonintrusive, economical, and scalable but warrants further validation. This study aims to examine whether there is a stronger association between acoustic metrics and PET imaging biomarkers compared to a traditional verbal memory test.

Biomarkers.

Background: Speech is a predominant mode of human communication. Speech digital recordings are inexpensive to record and contain rich health related information. Deep learning, a key method, excels in detecting intricate patterns, however, it requires substantial training data.

Public Health.

Background: Global health is increasingly burdened by oral diseases (ODs) affecting 3.9 billion people, and Alzheimer's disease with related dementias (AD/ADRD), impacting 46.8 million globally.

Public Health.

Background: Greater levels of physical activity are associated with improved cognition and decreased risk for dementia, but it is not clear when the potential benefits of physical activity on brain health are most beneficial throughout the life course. We examined associations between overall physical activity and incident dementia among adults in early adult life, midlife and late-life.

Method: Participants from the Framingham Heart Study Offspring cohort were included.

Public Health.

Background: Greater occupational complexity may be protective against dementia in later life, but it is unclear if it contributes to cognitive resilience and whether different aspects of occupational complexity are associated with resilience. We examined relationships between occupational complexity related to data, people, and things, and cognitive resilience to neurodegeneration.

Method: 1,699 participants from the Framingham Heart Study Offspring cohort who were aged ≥60 years, had a plasma total tau (t-tau) measure (a marker of neurodegeneration), and a neuropsychological (NP) exam visit within five years of the plasma t-tau measurement were included.

Public Health.

Background: Some evidence supports an association between traumatic brain injury (TBI) and greater risk of dementia, but the role of cognitive resilience in this association is poorly understood.

Method: 2,050 participants from the Framingham Heart Study Offspring cohort who were aged ≥60 year and had a plasma total tau (t-tau) measure at Exam 8 (2005-2008), and a neuropsychological (NP) exam visit within five years were included. Plasma t-tau was measured using the Simoa assay (Quanterix).

Public Health.

Background: Although traumatic brain injury (TBI) is known to be associated with short term mortality, its effects on long-term mortality remain less clear. TBI is also a well-known risk factor for dementia. We hypothesized that TBI would be associated with long-term mortality, particularly dementia-related mortality.

Biomarkers.

Background: Sleep apnea and insomnia are risk factors for dementia. Slower gait and increased gait variability are also associated with increased risk of MCI, linked to cognitive decline. Wearable digital sensors can serve as vital tools for measuring sleep and motor function.

Biomarkers.

Background: Type 2 diabetes and glucose metabolism have previously been linked to cognitive decline and higher risk of developing Alzheimer's disease (AD) dementia. Yet, the relation of glucose metabolism with amyloid and tau pathology remains unclear. This knowledge will help understanding the importance of glucose regulation in relation to AD.

Biomarkers.

Background: Plasma amyloid and tau levels are known to be associated with the risk of Alzheimer's disease (AD). In recent years, digital cognitive assessment has been increasingly recognized as a potential tool for long-term cognitive monitoring. This study aims to explore the potential of digital cognitive metrics as efficient and low-cost alternatives to plasma biomarkers.

Developing Topics.

Background: New blood-based and digital biomarkers for Alzheimer's disease (AD) make early detection possible at stages when novel, disease-specific therapies are likely to be most effective. These approaches may offer less invasive, more cost-effective alternatives to traditional methods such as cerebrospinal fluid (CSF) collection or positron emission tomography (PET) imaging for diagnosing and staging AD. Building care pathways leveraging blood-based and digital biomarkers starts with understanding the current biomarker landscape and considering opportunities for widespread implementation in primary care clinical practice.

Dementia Care Research and Psychosocial Factors.

Background: The deficit of unawareness of cognitive impairment (cognitive anosognosia) is known to be associated with adverse health outcomes, caregiver burden, and worse cognitive outcomes. A better understanding of cognitive self-awareness and the ability to self-judge cognitive performance among the general population would enable a rational design of cognitive screening and improve how subjective cognitive decline and self-reported errors at tasks like medication administration are interpreted.

Method: Participants were enrolled in the Framingham Heart Study, which is a community-based cohort with three generations of participants.

Obesity and the development of Parkinson's disease within the Framingham Heart study cohort.

Objective: To determine the role of obesity in the development of Parkinson's disease (PD).

Background: Obesity has been reported to be both a risk factor for PD, as well as potentially protective. The Framingham Heart Study (FHS) is a multigenerational longitudinal cohort study that was started in 1948, which is well-known for its cardiovascular health studies.

Global amyloid burden enhances network efficiency of tau propagation in the brain.

Background: Amyloid-β (Aβ) and hyperphosphorylated tau are crucial biomarkers in Alzheimer's disease (AD) pathogenesis, interacting synergistically to accelerate disease progression. While Aβ initiates cascades leading to tau hyperphosphorylation and neurofibrillary tangles, PET imaging studies suggest a sequential progression from amyloidosis to tauopathy, closely linked with neurocognitive symptoms.

Objective: To analyze the complex interactions between Aβ and tau in AD using probabilistic graphical models, assessing how regional tau accumulation is influenced by Aβ burden.

Epilepsy is associated with the accelerated aging of brain activity in sleep.

Objective: Although seizures are the cardinal feature, epilepsy is associated with other forms of brain dysfunction including impaired cognition, abnormal sleep, and increased risk of developing dementia. We hypothesized that, given the widespread neurologic dysfunction caused by epilepsy, accelerated brain aging would be seen. We measured the sleep-based brain age index (BAI) in a diverse group of patients with epilepsy.

Obfuscation via pitch-shifting for balancing privacy and diagnostic utility in voice-based cognitive assessment.

Introduction: Digital voice analysis is gaining traction as a tool to differentiate cognitively normal from impaired individuals. However, voice data poses privacy risks due to the potential identification of speakers by automated systems.

Methods: We developed a framework that uses weighted linear interpolation of privacy and utility metrics to balance speaker obfuscation and cognitive integrity in cognitive assessments.

Duration of Ice Hockey Play and Chronic Traumatic Encephalopathy.

Importance: Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head impacts (RHIs). Prior research suggests a dose-response association between American football play duration and CTE risk and severity, but this association has not been studied for ice hockey.

Objective: To investigate associations of duration of ice hockey play with CTE diagnosis and severity, functional status, and dementia.

Exploring the Perspectives of Older Adults on a Digital Brain Health Platform Using Natural Language Processing: Cohort Study.

Background: Although digital technology represents a growing field aiming to revolutionize early Alzheimer disease risk prediction and monitoring, the perspectives of older adults on an integrated digital brain health platform have not been investigated.

Objective: This study aims to understand the perspectives of older adults on a digital brain health platform by conducting semistructured interviews and analyzing their transcriptions by natural language processing.

Methods: The study included 28 participants from the Boston University Alzheimer's Disease Research Center, all of whom engaged with a digital brain health platform over an initial assessment period of 14 days.

Assessment of Wearable Device Adherence for Monitoring Physical Activity in Older Adults: Pilot Cohort Study.

Background: Physical activity has emerged as a modifiable behavioral factor to improve cognitive function. However, research on adherence to remote monitoring of physical activity in older adults is limited.

Objective: This study aimed to assess adherence to remote monitoring of physical activity in older adults within a pilot cohort from objective user data, providing insights for the scalability of such monitoring approaches in larger, more comprehensive future studies.