{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:00:28Z","timestamp":1790978428700,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"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\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000957","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; Dementia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Amyloid positivity does not reliably predict near\u2010term cognitive decline in preclinical Alzheimer's disease (AD). We tested whether digital cognitive phenotyping improves prognostic precision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Baseline performance on a brief self\u2010administered digital battery was analyzed in 1146 amyloid beta (A\u03b2)+ and 538 A\u03b2\u2212 cognitively unimpaired older adults from the Anti\u2010Amyloid Treatment in Asymptomatic Alzheimer's\/Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies. Unsupervised\n                      <jats:italic>k<\/jats:italic>\n                      \u2010means clustering identified cognitive phenotypes. Survival models examined time to Preclinical Alzheimer Cognitive Composite decline and Clinical Dementia Rating (CDR) progression. Associations with tau positron emission tomography and plasma phosphorylated tau (p\u2010tau)217 were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Four cognitive phenotypes emerged. One phenotype (18% of A\u03b2+ participants) showed the steepest cognitive decline, highest progression on the CDR, greater baseline medial temporal tau, and fastest neocortical tau accumulation over 4.6 years (hazard ratio [HR] for decline \u2248 2.9). Combining this phenotype with elevated plasma p\u2010tau217 identified a subgroup at markedly amplified risk (HR \u2248 4.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Digital cognitive phenotyping, especially when integrated with plasma biomarkers, identifies actionable risk heterogeneity and enables scalable precision prognostication in preclinical AD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71834","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:23:18Z","timestamp":1789467798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Digital cognitive phenotyping enhances risk stratification in preclinical Alzheimer's disease"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-5829","authenticated-orcid":false,"given":"Casey R.","family":"Vanderlip","sequence":"first","affiliation":[{"name":"Department of Neurobiology and Behavior University of California Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig E. L.","family":"Stark","sequence":"additional","affiliation":[{"name":"Department of Neurobiology and Behavior University of California Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.02.018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13859"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2305032"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.803"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2014.3375"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dad2.12217"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14154"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2023.1080366"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2020.38"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746\u2010024\u201000999\u20109"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.800126"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13919"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70355"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.6669"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201002049\u2010x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2024.122"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.2974"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25395"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43587\u2010025\u201000835\u2010z"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2016.01.028"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401\u2010025\u201002952\u2010w"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010024\u201049402\u2010x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2023.11.014"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/trc2.12446"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2025.10.005"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010023\u201000883\u20102"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13239"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14163"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.5319"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2024.134"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010025\u201003965\u20104"}],"container-title":["Alzheimer's &amp; Dementia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.71834","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/alz.71834","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alz.71834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:13:37Z","timestamp":1790331217000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/alz.71834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":31,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/alz.71834"],"URL":"https:\/\/doi.org\/10.1002\/alz.71834","archive":["Portico"],"relation":{},"ISSN":["1552-5260","1552-5279"],"issn-type":[{"value":"1552-5260","type":"print"},{"value":"1552-5279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71834"}}