CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes

Abstract Large language models (LLMs) have shown promising capabilities across diverse domains, yet their application to complex clinical prediction tasks remains limited. In this study, we present CARE-AD (Collaborative Analysis and Risk Evaluation for Alzheimer’s Disease), a multi-agent LLM-based...

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Main Authors: Rumeng Li, Xun Wang, Dan Berlowitz, Jesse Mez, Honghuang Lin, Hong Yu
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:npj Digital Medicine
Online Access:https://doi.org/10.1038/s41746-025-01940-4
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author Rumeng Li
Xun Wang
Dan Berlowitz
Jesse Mez
Honghuang Lin
Hong Yu
author_facet Rumeng Li
Xun Wang
Dan Berlowitz
Jesse Mez
Honghuang Lin
Hong Yu
author_sort Rumeng Li
collection DOAJ
description Abstract Large language models (LLMs) have shown promising capabilities across diverse domains, yet their application to complex clinical prediction tasks remains limited. In this study, we present CARE-AD (Collaborative Analysis and Risk Evaluation for Alzheimer’s Disease), a multi-agent LLM-based framework for forecasting Alzheimer’s disease (AD) onset by analyzing longitudinal electronic health record (EHR) notes. CARE-AD assigns specialized LLM agents to extract signs and symptoms relevant to AD and conduct domain-specific evaluations—emulating a collaborative diagnostic process. In a retrospective evaluation, CARE-AD achieved higher accuracy (0.53 vs. 0.26–0.45) than baseline single-model approaches in predicting AD risk 10 years prior to the first recorded diagnosis code. These findings highlight the feasibility of using multi-agent LLM systems to support early risk assessment for AD and motivate further research on their integration into clinical decision support workflows.
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institution Kabale University
issn 2398-6352
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publishDate 2025-08-01
publisher Nature Portfolio
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series npj Digital Medicine
spelling doaj-art-a51166a84b0d4d7f8373f652d745d4142025-08-24T11:52:10ZengNature Portfolionpj Digital Medicine2398-63522025-08-01811910.1038/s41746-025-01940-4CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notesRumeng Li0Xun Wang1Dan Berlowitz2Jesse Mez3Honghuang Lin4Hong Yu5Manning College of Information & Computer Sciences, University of Massachusetts AmherstMicrosoft CorporationCenter for Health Organization & Implementation Research, VA Bedford Health Care SystemChobanian & Avedisian School of Medicine, Boston UniversityDepartment of Medicine, UMass Chan Medical SchoolManning College of Information & Computer Sciences, University of Massachusetts AmherstAbstract Large language models (LLMs) have shown promising capabilities across diverse domains, yet their application to complex clinical prediction tasks remains limited. In this study, we present CARE-AD (Collaborative Analysis and Risk Evaluation for Alzheimer’s Disease), a multi-agent LLM-based framework for forecasting Alzheimer’s disease (AD) onset by analyzing longitudinal electronic health record (EHR) notes. CARE-AD assigns specialized LLM agents to extract signs and symptoms relevant to AD and conduct domain-specific evaluations—emulating a collaborative diagnostic process. In a retrospective evaluation, CARE-AD achieved higher accuracy (0.53 vs. 0.26–0.45) than baseline single-model approaches in predicting AD risk 10 years prior to the first recorded diagnosis code. These findings highlight the feasibility of using multi-agent LLM systems to support early risk assessment for AD and motivate further research on their integration into clinical decision support workflows.https://doi.org/10.1038/s41746-025-01940-4
spellingShingle Rumeng Li
Xun Wang
Dan Berlowitz
Jesse Mez
Honghuang Lin
Hong Yu
CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
npj Digital Medicine
title CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
title_full CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
title_fullStr CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
title_full_unstemmed CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
title_short CARE-AD: a multi-agent large language model framework for Alzheimer’s disease prediction using longitudinal clinical notes
title_sort care ad a multi agent large language model framework for alzheimer s disease prediction using longitudinal clinical notes
url https://doi.org/10.1038/s41746-025-01940-4
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