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Higher Amyloid and Tau Burden Is Associated With Faster Decline on a Digital Cognitive Test
Fu JF, Robinson T, Rodriguez Alonso M, Francis Malave A, Jutten RJ, Properzi MJ, Healy BC, Thompson JC et al.. Annals of clinical and translational neurology, 2025-11-10
Topic: Amyloid, tau and blood-test diagnosis
Objective A 2-min digital clock-drawing test (DCTclock) captures more granular features of the clock-drawing process than the pencil-and-paper clock-drawing test, revealing more subtle deficits at the preclinical stage of Alzheimer's disease (AD). A previous cross-sectional study demonstrated that worse DCTclock performance was associated with higher Aβ and tau burden in older cognitively normal (CN) participants. This study investigates whether longitudinal changes in DCTclock performance are associated with amyloid-β (Aβ) and tau burden in preclinical AD. Methods A total of 219 CN participants completed baseline and follow-up DCTclock assessments, baseline Aβ ([ 11 C]PiB) and tau ([ 18 F]Flortaucipir) PET imaging. Global Aβ and regional tau burden were estimated. Linear mixed models examined associations between longitudinal DCTclock and (1) Aβ, (2) tau, and (3) Aβ and tau burden, adjusted for age, sex, and education. Cognitive domain-specific performance and fine-grained features of DCTclock were analyzed. Results Elevated baseline Aβ or tau was most strongly associated with accelerated decline in DCTclock performance, particularly in the Information Processing cognitive domain, with stronger associations noted for tau burden. The associations were driven by pen-stroke latency-related features. Participants without elevated Aβ or tau burden demonstrated improved performance in these latency features, suggesting practice effects. Interpretation Longitudinal declines in DCTclock performance, especially in Information Processing involving speed and executive function, were linked to early Aβ and tau burden in preclinical AD. These findings highlight the potential of digital cognitive assessment tools for tracking disease progression and assessing therapeutic efficacy in clinical trials.
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APA 7th
Fu, J. F., Robinson, T., Rodriguez Alonso, M., Francis Malave, A., Jutten, R. J., Properzi, M. J., et al. (2026). Higher Amyloid and Tau Burden Is Associated With Faster Decline on a Digital Cognitive Test. Annals of clinical and translational neurology. https://doi.org/10.1002/acn3.70233
Vancouver
Fu JF, Robinson T, Rodriguez Alonso M, Francis Malave A, Jutten RJ, Properzi MJ, et al. Higher Amyloid and Tau Burden Is Associated With Faster Decline on a Digital Cognitive Test. Annals of clinical and translational neurology. 2026. doi:10.1002/acn3.70233. PMID: 41214447.
BibTeX
@article{fu2026-41214447,
author = {Fu, J. F. and Robinson, T. and Rodriguez Alonso, M. and Francis Malave, A. and Jutten, R. J. and Properzi, M. J. and Healy, B. C. and Thompson, J. C. and others},
title = {{Higher Amyloid and Tau Burden Is Associated With Faster Decline on a Digital Cognitive Test}},
journal = {Annals of clinical and translational neurology},
year = {2026},
doi = {10.1002/acn3.70233},
pmid = {41214447},
url = {https://doi.org/10.1002/acn3.70233}
}
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Key findings
- A previous cross-sectional study demonstrated that worse DCTclock performance was associated with higher Aβ and tau burden in older cognitively normal (CN) participants.
- This study investigates whether longitudinal changes in DCTclock performance are associated with amyloid-β (Aβ) and tau burden in preclinical AD.
- Results Elevated baseline Aβ or tau was most strongly associated with accelerated decline in DCTclock performance, particularly in the Information Processing cognitive domain, with stronger associations noted for tau burden.
- Participants without elevated Aβ or tau burden demonstrated improved performance in these latency features, suggesting practice effects.
- These findings highlight the potential of digital cognitive assessment tools for tracking disease progression and assessing therapeutic efficacy in clinical trials.
Study details
- Study designcross-sectional
- Participants219
- Evidence strengthModerate
How this study scored 66/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomized / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 38 of the 58 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Annals of clinical and translational neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 2 / 4 | 219 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41214447) |
| Free to read | 2 / 2 | Free to read |
| Points | 38 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 58 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
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