Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach

Abstract Background Subjective cognitive concerns (SCC) have emerged as important early indicators of Alzheimer’s disease (AD) risk. Traditional measures of SCC rely on recall-based assessments, which may be limited in capturing real-time fluctuations in cognitive concerns. Ecological Momentary Asse...

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Main Authors: Ángel García de la Garza, Caroline Nester, Cuiling Wang, Jacqueline Mogle, Nelson Roque, Mindy Katz, Carol A. Derby, Richard B. Lipton, Laura Rabin
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Alzheimer’s Research & Therapy
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Online Access:https://doi.org/10.1186/s13195-025-01720-y
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author Ángel García de la Garza
Caroline Nester
Cuiling Wang
Jacqueline Mogle
Nelson Roque
Mindy Katz
Carol A. Derby
Richard B. Lipton
Laura Rabin
author_facet Ángel García de la Garza
Caroline Nester
Cuiling Wang
Jacqueline Mogle
Nelson Roque
Mindy Katz
Carol A. Derby
Richard B. Lipton
Laura Rabin
author_sort Ángel García de la Garza
collection DOAJ
description Abstract Background Subjective cognitive concerns (SCC) have emerged as important early indicators of Alzheimer’s disease (AD) risk. Traditional measures of SCC rely on recall-based assessments, which may be limited in capturing real-time fluctuations in cognitive concerns. Ecological Momentary Assessment (EMA) offers a promising alternative by providing real-time data. This study aimed to link SCC assessed via EMA and traditional measures with blood-based AD biomarkers in a diverse, dementia-free, community-based sample based in the Bronx, NY. Methods Einstein Aging Study (EAS) participants underwent in-person, recall-based assessments of SCC during an in-clinic visit. Additionally, EMA SCC assessments were collected once per day over two weeks. Linear regressions were conducted to examine the relationships between SCC variables and plasma biomarkers adjusted for demographics and mild cognitive impairment (MCI) status. Results In N = 254 participants, EMA-reported SCCs demonstrated significant associations with AD biomarkers, particularly p-tau181 (β = 0.21, p = 0.001). Further, significant associations remain across both cognitive (cognitively unimpaired vs. MCI) and racial groups. In contrast, traditional SCC measures exhibited limited associations with these biomarkers. The findings highlight the added value of EMA in capturing SCCs that could indicate early ADRD risk. Conclusions EMA provides a more dynamic and potentially sensitive method for detecting early AD risk compared to traditional SCC assessments. These real-time measures could enhance early detection and clinical intervention, particularly in diverse and under-resourced populations. This study underscores the potential of EMA for broad applicability and inclusivity in monitoring AD progression and facilitating early therapeutic interventions.
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spelling doaj-art-5a7d9af3ecdc496ba19b355fea71d91c2025-08-20T03:18:30ZengBMCAlzheimer’s Research & Therapy1758-91932025-04-0117111310.1186/s13195-025-01720-yEnhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approachÁngel García de la Garza0Caroline Nester1Cuiling Wang2Jacqueline Mogle3Nelson Roque4Mindy Katz5Carol A. Derby6Richard B. Lipton7Laura Rabin8Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of MedicineDepartment of Psychiatry and Human Behavior, Brown UniversityDivision of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of MedicineDepartment of Psychology, College of Behavioral, Social and Health Sciences, Clemson UniversityDepartment of Human Development and Family Studies, Pennsylvania State UniversitySaul R. Korey Department of Neurology, Albert Einstein College of MedicineSaul R. Korey Department of Neurology, Albert Einstein College of MedicineSaul R. Korey Department of Neurology, Albert Einstein College of MedicineDepartment of Psychology, The City University of New YorkAbstract Background Subjective cognitive concerns (SCC) have emerged as important early indicators of Alzheimer’s disease (AD) risk. Traditional measures of SCC rely on recall-based assessments, which may be limited in capturing real-time fluctuations in cognitive concerns. Ecological Momentary Assessment (EMA) offers a promising alternative by providing real-time data. This study aimed to link SCC assessed via EMA and traditional measures with blood-based AD biomarkers in a diverse, dementia-free, community-based sample based in the Bronx, NY. Methods Einstein Aging Study (EAS) participants underwent in-person, recall-based assessments of SCC during an in-clinic visit. Additionally, EMA SCC assessments were collected once per day over two weeks. Linear regressions were conducted to examine the relationships between SCC variables and plasma biomarkers adjusted for demographics and mild cognitive impairment (MCI) status. Results In N = 254 participants, EMA-reported SCCs demonstrated significant associations with AD biomarkers, particularly p-tau181 (β = 0.21, p = 0.001). Further, significant associations remain across both cognitive (cognitively unimpaired vs. MCI) and racial groups. In contrast, traditional SCC measures exhibited limited associations with these biomarkers. The findings highlight the added value of EMA in capturing SCCs that could indicate early ADRD risk. Conclusions EMA provides a more dynamic and potentially sensitive method for detecting early AD risk compared to traditional SCC assessments. These real-time measures could enhance early detection and clinical intervention, particularly in diverse and under-resourced populations. This study underscores the potential of EMA for broad applicability and inclusivity in monitoring AD progression and facilitating early therapeutic interventions.https://doi.org/10.1186/s13195-025-01720-yCognitive concernsSubjective cognitive declineBlood-based biomarkersAlzheimer’s diseaseDementia riskEcological momentary assessments
spellingShingle Ángel García de la Garza
Caroline Nester
Cuiling Wang
Jacqueline Mogle
Nelson Roque
Mindy Katz
Carol A. Derby
Richard B. Lipton
Laura Rabin
Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
Alzheimer’s Research & Therapy
Cognitive concerns
Subjective cognitive decline
Blood-based biomarkers
Alzheimer’s disease
Dementia risk
Ecological momentary assessments
title Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
title_full Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
title_fullStr Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
title_full_unstemmed Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
title_short Enhanced associations between subjective cognitive concerns and blood-based AD biomarkers using a novel EMA approach
title_sort enhanced associations between subjective cognitive concerns and blood based ad biomarkers using a novel ema approach
topic Cognitive concerns
Subjective cognitive decline
Blood-based biomarkers
Alzheimer’s disease
Dementia risk
Ecological momentary assessments
url https://doi.org/10.1186/s13195-025-01720-y
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