Advancing Mobile Monitoring of Intraindividual Change in Alzheimer's Disease and Related Dementias: Building an Open and Accessible Infrastructure

About This Grant

Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) are urgent public health challenges, imposing a $345 billion annual economic burden in the U.S. and causing profound personal suffering. Early detection of cognitive changes during the preclinical stages, years or decades before diagnosis, is critical for advancing prevention and intervention strategies. However, traditional cognitive assessments lack the precision and sensitivity required to detect subtle changes and adapt to evolving research needs. This U19 proposal aims to establish the Mobile Monitoring of Cognitive Change (M2C2) Platform, an open-source, scalable, mobile-first system designed to administer ultra-brief cognitive tasks, collect high-frequency data, and apply advanced analytics to detect subtle cognitive changes linked to AD/ADRD risk. Aim 1 provides centralized coordination and shared resources through four specialized cores. The Administrative Core ensures alignment across components, the Technology and Data Management Core develops software for data collection and sharing, the Analytics Core delivers statistical tools for validation and interpretation, and the Community Engagement and Accessibility Core prioritizes accessibility, community engagement, and advancing availability of cognitive health resources. Together, these cores provide critical infrastructure to support the ambitious goals of the U19. Aim 2 evaluates how different high-frequency assessment (HFA) protocols using M2C2 tasks capture cognitive changes across multiple timescales and their relationships with AD/ADRD risk factors. Project 1 will assess the sensitivity of M2C2 tasks to biomarkers and contextual factors, such as social engagement, physical activity, and stress, generating actionable recommendations for task selection and protocol design to optimize measurement sensitivity while minimizing participant burden. Aim 3 focuses on developing, refining, and disseminating the M2C2 Platform to deliver robust tools for measuring cognitive change. Project 2 will prioritize flexible, user-friendly solutions that can integrate into different research workflows while ensuring long-term sustainability through open-source development and a multi-provider dissemination network. The M2C2 Platform will deliver validated tools and protocols for precise cognitive assessment and a scalable infrastructure to support prevention trials and accelerate research progress. These innovations will enhance our ability to identify and address AD/ADRD risks, ultimately reducing the burden of these diseases and improving quality of life for individuals and families.