{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:06:20Z","timestamp":1792209980074,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015595","name":"GHR Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Amyloid positron emission tomography (PET) and cerebrospinal fluid (CSF) biomarkers confirm Alzheimer's disease (AD) pathology but are impractical for large\u2010scale screening. Plasma phosphorylated tau at threonine 217 (p\u2010tau217), subjective cognitive concerns, and computerized cognitive testing are non\u2010invasive, scalable, and feasible to implement in large populations. We assessed their separate and combined predictive value for cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We analyzed 1064 cognitively unimpaired adults (ages 65\u201385 years) from the Anti\u2010Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4; amyloid\u2010positive) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN; amyloid\u2010negative) studies. Baseline assessments included apolipoprotein E (\n                      <jats:italic>APOE<\/jats:italic>\n                      ) \u03b54 status, hippocampal volume, amyloid PET, plasma p\u2010tau217, Cognitive Function Index (CFI), and Cogstate Computerized Battery (CCB). Cognitive impairment was defined as conversion from a Clinical Dementia Rating Global Score (CDR\u2010GS) of 0 to \u22650.5 over 240\u00a0weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>During the follow\u2010up, 34.1% developed cognitive impairment. Higher p\u2010tau217, higher CFI, and lower CCB were associated with higher odds of converting to CDR\u2010GS\u00a0&gt;0 across all cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>P\u2010tau217, CFI, and CCB each independently predict cognitive decline, offering practical, non\u2010invasive tools for early AD risk stratification and trial enrichment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71505","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:11:57Z","timestamp":1779948717000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Scalable markers for early cognitive decline: Plasma p\u2010tau217, subjective cognitive concerns, and digital testing: Results from the A4\/LEARN studies"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1585-3909","authenticated-orcid":false,"given":"Babak","family":"Khorsand","sequence":"first","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devin","family":"Teichrow","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Ghanbarian","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukai","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Ahmad","family":"Sajjadi","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal M.","family":"Glover","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Grill","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Rabin","sequence":"additional","affiliation":[{"name":"Brooklyn College and The Graduate Center \u2010 CUNY  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1307-4589","authenticated-orcid":false,"given":"Ali","family":"Ezzati","sequence":"additional","affiliation":[{"name":"Department of Neurology University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43587-023-00410-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002566"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213769"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.70128"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12217"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2305032"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-221118"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.26633"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2024.134"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2016.1256435"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.3375"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2024.123"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnc.70182"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105405"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-025-07457-y"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.3392"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14073"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-161294"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.70321"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1590\/1980-5764-dn-2021-0057"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-017-3150-z"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2024.2442598"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-65882-x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz70861_109007"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14537"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03965-4"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.70281"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjpad.2026.100503"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70355"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12219"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.803"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.70046"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12590"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-023-01341-3"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-23746-0"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13024-024-00711-1"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43587-025-00835-z"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13024-025-00843-y"}],"container-title":["Alzheimer's &amp; 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