Abstract

INTRODUCTION

Digital biomarkers for detecting Alzheimer's disease (AD) remain controversial due to inconsistent accuracy and unclear relationships with AD core biomarkers.

METHODS

This study recruited 428 Chinese older adults to determine the associations of artificial intelligence (AI)-assisted virtual reality (VR) cognitive scores with plasma amyloid beta (Aβ)42/Aβ40, phosphorylated tau (p-tau)217, glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), Aβ positron emission tomography (PET), tau PET, neurodegeneration, and cognition using generalized linear models, including age, sex, education, and apolipoprotein E ε4 as covariates.

RESULTS

The AI-VR cognitive scores were significantly correlated with plasma Aβ42/Aβ40, p-tau217, GFAP, NfL, Aβ PET, tau PET, hippocampal atrophy, temporal meta-region of interest cortical thinning, and cortical mean diffusivity increases, accurately identifying cognitively impaired patients from unimpaired individuals (area under curve [AUC]: 0.908–0.969) as well as classifying Aβ PET–positive individuals from negative group (AUC: 0.771–0.991).

DISCUSSION

This study comprehensively examined the capacity of a 5-minute AI-VR cognitive test for identifying abnormal cognition and AD biomarkers, offering a reliable digital marker for early AD detection in community settings.

Highlights

Digital virtual-reality cognitive tests correlate with AD biomarkers

Digital virtual-reality cognitive tests can identify cognitive impairment

Digital virtual-reality cognitive tests can classify those who are amyloid beta positron emission tomography positive from negative.

Title

Detecting Alzheimer's disease using digital virtual reality cognitive tests

Authors

Lili Fang, Xiang Fan, Anqi Li, Yue Cai, Pan Sun, Zhuonan Wei, Hui Chen, Keyan Yu, Guoyu Lan, Fernando Gonzalez-Ortiz, Lin Liu, Yiying Wang, Zhengbo He, Xin Zhou, Laihong Zhang, Mingxing Jiang, Lele Chen, Gaigai Lu, Lin Hu, Zhen Liu, Kaj Blennow, Dai Shi, Guanxun Cheng, Tengfei Guo

Journal Information

Alzheimer & Dementia (2025)

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