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 members of the Insight 46 study. We generated whole brain, hippocampal and white matter hyperintensity volumes at ages 69-73, 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.